A national action plan to meet health care quality information needs in the age of managed care

A national policy is needed to coordinate the various state and regional groups providing information on the quality of health care. Consumers, physicians, employers and health care plans all need information and the quality of health care. Although these information systems would be formed at the local level, they would use national standards to determine the quality of health care. Existing systems include the Minnesota Health Data Institute, the California Cooperative Health Care Reporting Initiative and the Cleveland Health Quality Choice program.
Concerted national action is needed to meet the growing demand for health care quality information among all health care stakeholders. We propose a coordinated national network of independent, public-private quality measurement alliances established through strong purchaser and consumer leadership at the state, regional, or local levels. These independent alliances could assume a variety of organizational forms, but all would undertake specific quality measurement and consumer information projects to meet local health care market needs by drawing on various combinations of the emerging national standardized quality measures. Local implementation of quality measures based on national standards will facilitate cross-market benchmarking and multistate comparisons useful not only to state and local market constituencies, but to national employers, health plans, provider organizations, and the federal government as well. Successful models of such alliances already exist that demonstrate the feasibility of this national strategy, but concerted national leadership and federal matching funding will be needed to meet the scope of implementation required in markets across the country. JAMA. 1998;279:1254-1258