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NBCH 2006 Public Policy Statement Health Care Information Technology Infrastructure

NBCH has a long history of working as an organization, namely though the eValue8 health plan performance evaluation instrument, to encourage member coalitions, employers and providers to collaborate at the local, regional, and national level to improvement in the quality, safety, and efficiency of health care through the interoperability of standardized electronic information technology.


NBCH believes that successfully transforming our nation's health care information technology capability requires strong national leadership, infrastructure development, and financial incentives along with alignment of national quality-based standards and capacity building of effective grassroots-level implementation program.


A major step in the right direction is the recent Executive Order signed by President Bush solidifying the federal government's commitment to improve standardization of health care information transparency and provider quality measurement by harmonizing health care purchasing practices of federal government, state governments and large employers. As the provider of 25 percent of health benefits to insured Americans, it makes sense for the federal government to lead the way on setting national standards for transparency and measurement.


This Executive Order, which goes into effect January 1, 2007, is a very exciting and long overdue federal policy development that certainly will improve our organization's ability to evolve value-based purchasing. It also demonstrates that the Bush Administration understands that effective health care reform ultimately is a local effort, and that employers and local community collaboration play an absolutely essential role in getting information on the quality and cost of care to the American public.


Ultimately, under the President's long-term HIT plan, local information on the quality and cost of care for most Americans would be available from the collaboration of health care providers, public and private payers, and other stakeholders in different regions of the country. The collaboration by providers and payers would create an unprecedented broad and reliable foundation of information on the quality and price of services delivered by each health care provider. Quality and cost measures developed through this process would be made available to consumers. As part of the Administration's ongoing campaign for health care transparency, the U.S. Department of Health and Human Services (HHS) has launched a dedicated Web site for health care transparency: www.hhs.gov/transparency/.


NBCH supports the following strategy to advance and harmonize the purchasing practices of the federal government, state governments and large employers.  

  • Adopt interoperable health information technology (HIT) standards which are currently being developed by the American Health Information Community (AHIC) so that health information and records can be shared much more easily within the health care system;
  • Begin using common quality measures for health care providers which are being developed by the Hospital Quality Alliance (HQA) and the Ambulatory Care Quality Alliance (AQA);
  • Pay health care providers on the basis of their performance.

Related to the Executive Order, a federally-sponsored program currently is underway in six geographic areas that will examine best practices for aggregating and sharing information. The goal of these pilot sites is to provide total price and quality information to those enrolled in the federally-administered or sponsored programs. However, much of this information is also intended for access by the general public in an electronic format. We are pleased that the Administration is planning to expand the number of community-based collaboratives by the end of 2008, and NBCH will make every effort to help appropriate member coalitions lead and participate in these collaboratives.


Another step in the right direction is the US House of Representatives' approval of the "Better Health Information System Act" (HR 4157) on July 27, 2006 to encourages greater use of health care information technology (Health IT) through the development of national interoperability standards for the storage and transmission of health care information. The House bill also relaxes the federal anti-kickback statute to allow hospitals to provide physicians with health IT hardware and software. Efforts should now focus on conferencing HR 4157 and Senate-passed (S 1418) legislation to resolve differences and produce a consensus bill for the President to sign before Congress adjourns this session.


NBCH participates in several important initiatives to advance health care quality and transparency: the Consumer-Purchaser Disclosure Group, a broad-based coalition of employer and consumer groups supporting efforts to measure and reward providers who deliver higher quality, evidence-based care more efficiently, and the newly formed National Quality Alliance Steering Committee that is a combined effort of both the AQA and the Hospital Quality Alliance. Most recently, the Steering Committee has been focusing on resources needed to improve and expand the Administration's HIT community collaborative effort. NBCH's President & CEO, Andy Webber, serves on the Steering Committee's Pilot Infrastructure Support Work Group, which is one of five work groups, and is focused on identifying ways to provide infrastructure support to the community collaborative pilot sites. NBCH also works closely with the Leapfrog Group and Bridges to Excellence program, through group educational meetings and programs, to encourage hospital and physician level performance data transparency. Furthermore, for the past few years, NBCH has been involved with the E-Health Initiative to drive health care efficiency, quality and safety through standardized interoperable information technology