Affordable Care 


Healthcare expenditures in the U.S. are unmatched by any country in the world. Unfortunately, this spending has not resulted in better health for Americans, and in general, the U.S. underperforms compared to other industrialized nations in terms of mortality, patient satisfaction, access to care, and quality of healthcare. Our healthcare spending continues to increase at an unsustainable rate of seven percent per year, and is largely focused on treating acute and chronic illness rather than promoting health and preventing illness and disability.

The National Quality Strategy emphasizes the need to make quality care more affordable for people, families, employers, and governments by focusing on two goals:

  1. Ensuring affordable and accessible high-quality healthcare for people, families, employers, and governments.
  2. Supporting and enabling communities to ensure accessible, high-quality care while reducing unnecessary costs.

Many opportunities exist to address affordability, lower healthcare costs, thereby increasing value and creating a less wasteful healthcare system. In 2012, the Institute of Medicine noted that six factors contributing to excess healthcare costs – unnecessary services, inefficiently delivered services, excess administration costs, prices that are too high, missed prevention opportunities, and fraud – account for approximately $750 billion in spending. Through its endorsement projects, its membership, and its partnerships, NQF is working to address affordability by elevating these issues to the forefront of policy discussions.

Related NQF Work

  • NEW! Home and Community-Based Services Quality
    This project will develop a conceptual framework and perform an environmental scan to address performance measure gaps in home and community-based services to enhance the quality of community living.
     
  • NEW! Rural Health
    Under contract with HHS, this project will allow NQF—through a multistakeholder, collaborative process—to provide recommendations to HHS regarding performance measurement issues for rural and low-volume providers.
     
  • Measuring Affordable Care
    This project will explore what healthcare affordability means from consumer and patient perspectives and to understand what information patients and consumers need to find affordable care.
    ACCESS RWJ FINAL PAPER - Improving Cost and Affordability Measurement Across the Performance Measurement Enterprise
     
  • Linking Cost and Quality Measures
    This project will explore current approaches to measuring efficiency and develop best practices for combining cost measures with clinical quality measures to improve efficiency of care.
    ACCESS RWJ FINAL PAPER - Improving Cost and Affordability Measurement Across the Performance Measurement Enterprise
     
  • Cost and Resource Use Measures
    This project will seek to recognize and endorse new cost and resource use measures that will facilitate further understanding of the resource use driven by providers and clinicians for the care of patients with various conditions.
     
  • Episode Grouper Evaluation Criteria
    The project will explore the best approaches for collecting costs information for episodes of care.
     
  • MAP Families of Measures Report
    Specifically related to the NQF Affordability portfolio, The Affordability Task Force was charged with developing a MAP Affordability Family of Measures. The project selected a suite of measures for value-based purchasing and public programs that may help promote affordability. The Affordability suite of measures can be found in the final report from the Measure Applications Partnership (MAP) that identifies families of measures—sets of related available measures and measure gaps that span programs, care settings, levels of analysis, and populations-related to three National Quality Strategy priorities: Affordability, Person- and Family-Centered Care, and Population Health.

Recommended Reads

Singer E, Couper MP, Fagerlin A, et al. The role of perceived benefits and costs in patients’ medical decisions. Health Expect. 2014;17(1):4-14.

Callaghan BC, Burke JF, Fedlman EL. How neurologists can choose (even more) wisely: prioritizing waste reduction targets and identifying gaps in knowledge. JAMA. 2014;311(16):1607-1608.

Anderson JL, Heidenreich PA, Barnett PG, et al. ACC/AHA statement on cost-value methodology in clinical practice guidelines and performance measures: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(21):2304-2322.

Kuehn BM. Guidelines, online training aim to teach physicians to weigh costs of care, become better stewards of medical resources. JAMA. 2014;311(23):2368-2370.

Available at http://www.rwjf.org/en/research-publications/find-rwjf-research/2012/10/physicians--views-of-comparative-information-on-costs-and-resour.html

Tell us what you think

What issues related to affordability are you working on? What measures are you using? We want to hear about it.

Please email us about your own efforts to improve affordability at affordability@qualityforum.org. 

 

 

NQF Resources

The Field Guide is an online resource designed to help you easily access NQF resources.   

Find Measures

Use NQF's Quality Positioning System (QPS) to find measures related to Affordable Care.

Find measures now! 

Learn from Others

Use NQF's Online Action Registry (OAR) to learn about other efforts in the field to improve affordability. 

Find actions now!