# Presentation: 033993

## Chartered Value Exchanges (CVEs)

- September 2008
- CVEs may wish to tailor this slide deck for use with stakeholders in your community.

## U.S. Department of Health and Human Services

**U.S. Department of Health and Human Services**

**The Secretary**

**Administration for Children **
**and Families  (ACF)**

**Agency for Healthcare Research**
**and Quality (AHRQ)**

**Centers for Disease Control **
**and Prevention (CDC)**

**Agency for Toxic Substances **
**and Disease Registry (ATSDR)**

**Program Support Center (PSC)**

**Substance Abuse and Mental Health **
**Services Administration  (SAMHSA)**

**National Institutes of Health (NIH)**

**Indian Health Service (IHS)**

**Health Resources and Services **
**Administration  (HRSA)**

**Food and Drug Administration  (FDA)**

**Centers for Medicare & Medicaid**
**Services (CMS)**

**Administration on Aging (AoA)**

## AHRQ’s Mission

- Improve the quality, safety, efficiency and effectiveness of health care for all Americans

## Quality of care in US – Medical accidental deaths outnumber others

**Source: **_**To Err is Human: Building a Safer Health System**_**, Institute of Medicine, 1999.**

## 2001 IOM Report, Crossing the Quality Chasm

- Scientific review documents the scale and gravity of quality problems
- More than 70 publications cite  quality problems
- 	...*between the health care we have and the care we could have lies not just a gap, but a chasm*.

## Medical Care Often Not Optimal 

**Medical Care Often Not Optimal **
** **
**Failure to Treat Patients Fully Spans Range of What Is Expected of Physicians and Nurses**

**Study:  U.S.**
**Doctors are not following the guidelines for ordinary illnesses**

**The American healthcare system,**
**often touted as a cutting-edge **
**leader in the world, suddenly**
**finds itself mired in serious **
**questions about the ability of its**
**hospitals and doctors to deliver**
**quality care to millions.**

**Medical errors corrode**
**quality of healthcare system**

## RAND study – Doctors provide appropriate health care only about half the time

- Percentage of time

- E. McGlynn, S. Asch, J. Adams, et al., The Quality of Health Care Delivered to Adults in the United States, *N Engl J Med*, 2003.

## Transformational Goal of CVEs: Improved Quality and Efficiency

**Transformational Goal of CVEs: Improved Quality and Efficiency**

- Low

- High

- Low

- High

**Quality**

**Efficiency**

## What Will This Take?

- Good measures and data
- Strong local coalitions
- Evidence-based reporting, payment strategies
- Evidence, tools, strategies for improvement
- Collaboration across sites

## Focus of AHRQ Learning Network for CVEs

- 	Technical assistance content spans contemplation, design and implementation decisions across the following activities identified by user/stakeholders as high priority:
- Collaborative leadership & sustainability
- Public at-large engagement
- Quality & efficiency measurement
- Public reporting
- Provider incentives
- Consumer incentives
- Capacity for improving quality
- HIT/HIE

## AHRQ Learning Network Builds on Secretary’s Value-Driven Health Care Principles

- All health care is “local”
- Transparency – accurate meaningful information on quality and cost – is key to provider improvement and consumer engagement
- Collaboratives involving key stakeholder groups – public and private payers, providers, plans and consumers* – hold promise to foster requisite reforms
- 	*and in some cases State data organizations, Quality Improvement Organizations, and health information exchanges

## Improving Quality 

- The need for leadership has never been greater.
- All public and private health care constituencies must commit to a shared agenda that can raise the quality of health care for all.
- -- 2001 IOM Report, *Crossing the Quality Chasm*