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Statements on Introduced Bills and Joint Resolutions

Location: Washington, DC




S. 2358. A bill to amend title 38, United States Code, to establish a Hospital Quality Report Card Initiative to report on health care quality in Veterans Affairs hospitals; to the Committee on Veterans' Affairs.


S. 2359. A bill to amend title XVIII of the Social Security Act to establish a Hospital Quality Report Card Initiative under the Medicare program to assess and report on health care quality in hospitals; to the Committee on Finance.

Mr. OBAMA. Mr. President, today I am introducing legislation that would expand and improve quality reporting for our Nation's hospitals through the establishment of a national Hospital Quality Report Card Initiative.

Study after study has documented that health care quality in the United States is inconsistent and inadequate. The landmark 2003 RAND report by Beth McGlynn found that the chance of Americans getting recommended care is not much greater than the flip of coin. For many conditions, the chances are even worse--only about a third of diabetics and a quarter of patients with atrial fibrillation and hip fractures receive the right treatment, as do only about 10 percent of patients with alcohol dependence. Patients are suffering, and the financial costs of poor care are staggering. We can and must do more to ensure that every patient gets the right care, at the right time, in the right way.

One way to help improve health care quality is to measure and report the quality of care in our nation's hospitals. Hospital quality reports can help patients and consumers choose the hospital that will best serve their health needs. Purchasers and payers can use hospital quality information to help their decision-making about where employees and members can go for care. Hospitals and health care professionals would similarly benefit from identification of areas of need, and opportunities for quality improvement and cost containment. And finally, with greater quality reporting and transparency, we can begin to have an honest dialogue about health care quality and how to reform our health care system.

Several States have already developed and implemented hospital report card initiatives, and I am proud to say that Illinois began its own report card initiative in January of this year--an initiative that I spearheaded when I served in the Illinois State Senate.

On the national level, the Centers for Medicare and Medicaid Services (CMS) and the Hospital Quality Alliance have partnered to identify and encourage submission of quality measures for several health conditions, on a voluntary basis, in exchange for greater federal reimbursement. The Deficit Reduction Act codified this initiative earlier this year.

The Hospital Report Card Act, which I am introducing today, takes quality measurement one step further, by mandating that the Secretary expand and improve upon current quality reporting for hospitals. Within 18 months, the Secretary would establish a formal Hospital Report Card Initiative, and publish reports on individual hospital quality using data submitted for the value based purchasing program at CMS, but also including other data available to the Secretary. The report cards would report quality measures that align with those used in the National Healthcare Quality Report, including measures of effectiveness, safety, timeliness, efficiency, patient-centeredness, and equity. In addition, the report cards would provide information on other quality priorities for patients, such as staffing levels of nurses, rates of infections acquired in hospitals, volume of procedures performed, and availability of specialized care. The Secretary would also report measures of relevance to a number of priority populations, including women, children and minorities.

The bill requires the Secretary to take steps to ensure that all reported data is accurate and fairly represents hospital quality, and that hospitals have an opportunity to participate in the development of the report card initiative. I also want to make sure that sick patients have full access to the best hospitals, and so the report cards will risk-adjust quality data, so that hospitals are not inadvertently penalized for caring for more challenging patient populations.

We are hearing a lot of rhetoric about patient empowerment and consumer-driven health plans. However, we can't expect patients to make the best choices for their health care in the absence of accurate information on quality and costs. Similarly, we can't expect hospitals to recognize their areas of deficiencies or strengths without a critical look inwards. Finally, we can't expect the Nation at large to support and embrace healthcare reform without greater awareness of quality problems.

The Hospital Quality Report Card Act will help the Nation take one step closer to improving health care quality and containing costs, and I hope my colleagues will join me in passing this critical legislation.

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