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Administration Aims to Set Health-Care Standards

By David S. Broder
Washington Post Staff Writer
Monday, August 7, 2006

CHARLESTON, S.C., Aug. 6 -- The Bush administration will soon launch an ambitious effort to require that all providers of federally financed health care adopt quality-measurement tools and uniform standards for their information technology, Health and Human Services Secretary Mike Leavitt said Sunday.

Leavitt told a session of the National Governors Association's annual meeting that "in a matter of weeks," President Bush will sign an executive order setting the new requirements. He promised that by year's end, a majority of the 100 largest private employers will sign similar contracts with the hospitals and doctors they use to care for their workers.

He urged the governors to follow suit by signing up the groups that take care of state employees and Medicaid recipients.

The goal of the initiative, Leavitt said, is to reduce health-care cost inflation while increasing the quality of medical services individuals receive.

The executive order would affect doctors and hospitals serving the Medicare population of elderly Americans and people served by any other federally financed service.

It would require those health providers to join with the government to standardize the requirements for information technology systems coming into their facilities; set standards for care of specific health problems; and develop uniform methods of measuring and reporting the outcomes of treatments.

Leavitt cautioned that the first standards in all three areas would be "pretty basic," but said they would provide a foundation for a future system in which patients could make "much more informed decisions" about where to go for treatment and what it is likely to cost.

Leavitt said that the demand for such information is large and that tools are becoming available to supply it. He said he had contacted executives of 21 of the 100 largest private employers and "21 of 21" are ready to sign such contracts with their own suppliers. That number will grow rapidly in coming weeks, he said.

Governors expressed interest in using Leavitt's model in their states but voiced some skepticism about the readiness of doctors to have their work evaluated.

Leavitt insisted that the physicians with whom he has met "want the standards" set for care in their specialties, in part because they want to evaluate their own performance against that of their peers, and in part because rewards for quality -- which Leavitt said these measurements would make possible -- might offset the loss of income threatened as budget pressures reduce their reimbursements for Medicare patients.

Leavitt conceded that many of the doctors are "skeptical we can create a system that measures quality accurately," but he said some specialties are already developing such standards and more can be nudged into doing so.

As for the standardization of information technology, now moving in rather haphazard fashion into hospitals and doctors' practices, Leavitt said HHS teams have finished drafting recommended standards for four basic functions: registering patients, reporting lab results, writing prescriptions, and providing secure communication channels between patients and doctors and among health-care providers.

Those standards will also be written into the proposed executive order, he said.

Also on the health-care front, two Democratic governors said in interviews Sunday that they intend to copy the model pioneered this year in Massachusetts by Gov. Mitt Romney (R) and attempt to provide universal health insurance. New Mexico's Bill Richardson and Michigan's Jennifer M. Granholm said they have begun to move in the direction Romney has taken, requiring individuals to buy policies and subsidizing the premiums for those with limited incomes.

At their closed session at noon, all of the governors present agreed to sign a letter to Congress protesting a provision in the House version of the defense authorization bill that would expand the president's authority to take over the National Guard in case of emergencies.

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