[Congressional Record Volume 152, Number 25 (Thursday, March 2, 2006)]
[Senate]
[Pages S1651-S1652]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. OBAMA:
  S. 2359. A bill to amend title XVIII of the Social Security Act to 
establish a Hospital Quality Report Card Initiative under the Medicare 
program to assess and report on health care quality in hospitals; to 
the Committee on Finance.
  Mr. OBAMA. Mr. President, today I am introducing legislation that 
would expand and improve quality reporting for our Nation's hospitals 
through the establishment of a national Hospital Quality Report Card 
Initiative.
  Study after study has documented that health care quality in the 
United States is inconsistent and inadequate. The landmark 2003 RAND 
report by Beth McGlynn found that the chance of Americans getting 
recommended care is not much greater than the flip of coin. For many 
conditions, the chances are even worse--only about a third of diabetics 
and a quarter of patients with atrial fibrillation and hip fractures 
receive the right treatment, as do only about 10 percent of patients 
with alcohol dependence. Patients are suffering, and the financial 
costs of poor care are staggering. We can and must do more to ensure 
that every patient gets the right care, at the right time, in the right 
way.
  One way to help improve health care quality is to measure and report 
the quality of care in our nation's hospitals. Hospital quality reports 
can help patients and consumers choose the hospital that will best 
serve their health needs. Purchasers and payers can use hospital 
quality information to help their decision-making about where employees 
and members can go for care. Hospitals and health care professionals 
would similarly benefit from identification of areas of need, and 
opportunities for quality improvement and cost containment. And 
finally, with greater quality reporting and transparency, we can begin 
to have an honest dialogue about health care quality and how to reform 
our health care system.
  Several States have already developed and implemented hospital report 
card initiatives, and I am proud to say that Illinois began its own 
report card initiative in January of this year--an initiative that I 
spearheaded when I served in the Illinois State Senate.
  On the national level, the Centers for Medicare and Medicaid Services 
(CMS) and the Hospital Quality Alliance have partnered to identify and 
encourage submission of quality measures for several health conditions, 
on a voluntary basis, in exchange for greater federal reimbursement. 
The Deficit Reduction Act codified this initiative earlier this year.
  The Hospital Report Card Act, which I am introducing today, takes 
quality measurement one step further, by mandating that the Secretary 
expand and improve upon current quality reporting for hospitals. Within 
18 months, the Secretary would establish a formal Hospital Report Card 
Initiative, and publish reports on individual hospital quality using 
data submitted for the value based purchasing program at CMS, but also 
including other data available to the Secretary. The report cards would 
report quality measures that align with those used in the National 
Healthcare Quality Report, including measures of effectiveness, safety, 
timeliness, efficiency, patient-centeredness, and equity. In addition, 
the report cards would provide information on other quality priorities 
for patients, such as staffing levels of nurses, rates of infections 
acquired in hospitals, volume of procedures performed, and availability 
of specialized care. The Secretary would also report measures of 
relevance to a number of priority populations, including women, 
children and minorities.
  The bill requires the Secretary to take steps to ensure that all 
reported data is accurate and fairly represents hospital quality, and 
that hospitals have an opportunity to participate in the development of 
the report card initiative. I also want to make sure that sick patients 
have full access to the best hospitals, and so the report cards will 
risk-adjust quality data, so that hospitals are not inadvertently 
penalized for caring for more challenging patient populations.
  We are hearing a lot of rhetoric about patient empowerment and 
consumer-driven health plans. However, we can't expect patients to make 
the best choices for their health care in the absence of accurate 
information on quality and costs. Similarly, we can't expect hospitals 
to recognize their areas of deficiencies or strengths without a 
critical look inwards. Finally, we can't expect the Nation at large to 
support and embrace healthcare reform without greater awareness of 
quality problems.
  The Hospital Quality Report Card Act will help the Nation take one 
step closer to improving health care quality and containing costs, and 
I hope my colleagues will join me in passing this critical legislation.

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