Focusing on a few items begs for gaming the system, and thereby undermines the value of these items for outcomes analysis. This option is a destructive short-term solution, very shortsighted, and should be abandoned. From a national health policy perspective, the more consolidated data that we have about health care needs and health care delivery the better we will be able to plan for the future. There is also a regulatory issue in that the Medicare Conditions of Participation require that quality standards be met for all patients served by Medicare certified agencies. In a closely related example, these privacy concerns have not been an issue in nursing homes where MDS data is collected on all patients.
Information drives decision-making.
It would be ironic that we would have better information from a setting that all of us dread, than from the home and community that we all hope to be the setting for our own long term care. Moreover, it is important to know whether changes in the Medicare reimbursement system will affect the quality of care for patients in other programs. There is value in having case-mix and outcome data that cuts across payer categories, even for short stay patients. In fact, such analyses have already revealed possible quality problems as the number of visits drops. Once the privacy concerns and issues of data collection, transmission and processing have been addressed, data should be shared with the government oversight entities.