Support Four Cornerstones of Value, Says HHS

During his address at the recent National Summit for Employers on Health Care Transparency, HHS Secretary Michael Leavitt called on employers across the nation to commit to health care quality and cost reporting for employees.

"If we are going to get a handle on health care costs -- and we must -- we first need to know what our costs are and what we are getting for our money," Leavitt told the audience, which included representatives from more than 180 companies and 25 associations, at the Nov. 17 meeting in Washington.

"Our nation's private employers are the major source of health insurance for Americans, and they can help us provide the information consumers need to achieve better value for their health care dollars," said Leavitt.

He called on all stakeholders, including physicians, health insurance plans and third-party administrators, to support the four cornerstones of value-driven health care, which include

Leavitt also outlined an aggressive timeline for implementing these cornerstones. By spring 2007, when payers put out their requests for proposals for 2008, he wants more than 60 percent of the marketplace to include the four cornerstones as a significant part of their purchasing criteria.

Leavitt invited the companies present at the summit to make a formal commitment to the plan by signing a Purchaser Statement of Support for value-driven health care.

To drive home the challenges, he recounted two conversations -- out of thousands he's conducted around the country -- about the need for value-driven health care. One conversation, said Leavitt, was with a corporate human resources officer; the other was with a physician in solo practice.

The executive's priority for ensuring the survival of his company was to reduce the $1 billion-a-year employee health care tab by measuring the quality of the health care delivered. The physician was concerned about fair and accurate reporting of those quality measures, said Leavitt.

The physician told Leavitt: "Look, I want to know if I'm providing quality of care to my patients, but if you're going to show that information to my patients, it needs to be right. It is unfair to my patients -- it is unfair to me -- if I'm portrayed as a poor physician when I'm actually a good one."

Recognizing the tension between the two viewpoints, Leavitt told the audience that the creation of a better health care system would require everyone's cooperation.

"This approach is about providing better information for everyone, up and down the health care system," said Leavitt. "Consumers and payers need this information, but physicians and hospitals need it just as much. That's where quality and value improvement will really take place."

The federal government is committed to the four cornerstone goals, said Leavitt, referring to President Bush's Aug. 22 executive order directing federal agencies to "make the four cornerstones a major priority in the way they buy and organize health care." Medicare, the Veterans Affairs health system, the Federal Employees Health Benefits Program and some other federal health care programs will begin delivering on the four goals in the coming year, said Leavitt.