News Briefs
News Briefs
National Quality Forum launches health care improvement effort
The National Quality Forum (NQF), a public-private partnership and not-for-profit membership organization, aims to develop and implement a national strategy for measuring and reporting health care quality has designed an agenda to improve quality measurement and reporting in all sectors delivering health care. The NQF plans to:
• Develop a framework to guide a national strategy for measuring and reporting health care quality.
• Ensure systemwide capability to measure and report on quality.
• Marshal market demand for quality.
• Foster and inform consumer choice and use of quality information.
• Promote collection and dissemination of data that providers need to improve quality.
• Reduce the burden on providers and health plans of measuring quality by promoting standardization of quality measurement and reporting.
"The National Quality Forum is committed to using quality measurement and reporting to drive quality improvement in our health care system," says National Quality Forum chairwoman Gail Warden, president and CEO of Henry Ford Health System in Detroit. "By bringing all segments of the health care industry together to address quality, we can make a real difference in improving the health of all Americans."
The forum also announced the appointment of Kenneth W. Kizer, MD, as president and CEO of the organization. Kizer most recently served as under secretary for health in the Department of Veterans Affairs. "In virtually every other industry, improvements in quality result in a reduction in cost," he says.
The organization was proposed as part of the 1998 findings of the President’s Advisory Commission on Consumer Protection and Quality in the Health Care Industry. NQF is primarily a membership dues-financed organization, but receives significant public and private funding from foundation and corporate grants. For more information on the NQF, contact Patrick Riccards or Emily Heil at (202) 667-0901, or view NQF’s Web site at www.Qualityforum.org.
Medicare cuts hurting access to home health care
A recent report from the George Washington University Medical Center on Medicare cutbacks for home care services brought about by the Balanced Budget Act of 1997 indicates the well-being of most vulnerable home care patients is in jeopardy.
The study reviewed the effects spending cuts enacted by the new interim payment system have on Medicare beneficiaries receiving home health services. It found that skilled nursing staff in the reporting agencies declined by 23% since 1994, thus leaving fewer professional home care workers to serve the needs of a growing population of elderly.
It also showed that chronically ill patients are experiencing the greatest disruption of Medicare-reimbursed care. Data from the Health Care Financing Administration shows that almost 2,500 Medicare-certified agencies have closed since the cuts became effective.
Val J. Halamandaris, president of the National Association for Home Care (NAHC), says, "The interim payment system is designed in such a way that it makes it financially impossible for agencies to provide an adequate level of care to the frail patients who need it the most."
Founded in 1982, NAHC is the largest trade association serving the nation’s home care agencies, hospices, and home care aide organizations. For further information, contact Valerie Erb Tully of NAHC, (202) 547-7424. Web site: www.nahc. org.
AARP study says private drug coverage insufficient
According to a recent study conducted by the Public Policy Institute of the American Association for Retired persons (AARP), the prescription drug insurance coverage is insufficient for over half of Medicare beneficiaries with high out-of-pocket prescription drug costs. The study also shows that out-of-pocket drug costs are a potential problem for beneficiaries at all income levels.
Theresa Varner, director of AARP’s Public Policy Institute, says, "What we found is that private sector drug coverage is often inadequate, and that limiting a Medicare drug benefit only to those with low incomes would exclude many beneficiaries in need of assistance."
Outpatient prescription drugs that are not covered under Medicare can be a substantial financial burden. John Rother, AARP’s director of legislation and public policy, says, "Many argue that because roughly two-thirds or Medicare beneficiaries have some type of coverage, a Medicare drug benefit for everyone is not necessary. But this study provides evidence that the current system is not working for beneficiaries."
In 1999, noninstitutionalized beneficiaries of all ages are projected to spend an average of $410 on prescription drugs and $2,370 (18% of income) on total out-of-pocket health care costs. Those with higher-than-average costs are more likely to: be in poor or fair health; severely limited in daily living activities; age 75 and older or under 65 and disabled; lack drug coverage; and have individually purchased supplemental insurance.
"It’s those unpredictable changes in a person’s health status and drug spending that present the biggest problems," says Rother. "Designing a drug benefit that protects those currently in need and those who will face substantial costs in the future will require coverage for all beneficiaries, as well as adequate financing."
Women do most care for the dying
It’s usually a female relative who provides most of the day-to-day care nursing care for a dying family member, including tasks, such as changing feeding tubes and giving intravenous medication, according to a study by the National Family Caregivers Association (NFCA). The study — the first to address this issue in the past 10 years — found that patients’ wives, daughters, and sisters carried most of the burden for care in about three-quarters of the cases studied, and that nearly a quarter of those dying from diseases other than cancer fail to get all the kinds of care they need.
NFCA studied 988 people whose doctors expected them to die within six months. It excluded those with disabling injuries, Alzheimer’s, and chronic illnesses. Suzanne Mintz, president of the NFCA, describes the study as "a wake-up call to address the needs of caregivers."
In addition to showing that physicians are more likely to arrange for home health agencies to assist family members in caring for cancer patients, perhaps because they see cancer patients as dying.
• About 15% of patients with terminal cancer have unmet care needs, compared to 23% of patients dying from other illnesses. Those requirements include transportation for medical services, housekeeping, personal care, such as bathing, getting dressed, and nursing care.
• Especially poor patients are more likely to receive help from paid caregivers, such as home health agencies.
• Women are called upon to help dying family members, but typically rely on paid help when they themselves are dying.
Because hospitals are discharging patients sooner and sometimes sicker than they have in the past, family caregivers need help in learning many caregiving tasks and professional home health caregivers are the logical teachers.
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.