[Weekly Compilation of Presidential Documents Volume 34, Number 11 (Monday, March 16, 1998)]
[Pages 429-431]
[Online from the Government Publishing Office, www.gpo.gov]

<R04>
Memorandum on the Establishment of the Quality Interagency Coordination 
Task Force

March 13, 1998

Memorandum for the Secretary of Defense, the Secretary of Labor, the 
Secretary of Health and Human Services, the Secretary of Veterans 
Affairs, the Director of the Office of Personnel Management

Subject: Establishment of the Quality Interagency Coordination Task 
Force

    Last November, I endorsed the ``Patient Bill of Rights'' recommended 
by the Advisory Commission on Consumer Protection and Quality in the 
Health Care Industry (the ``Quality Commission''). On February 20, 1998, 
after receiving your encouraging reports from the Vice President about 
the degree to which your agencies are in compliance with these rights, I 
directed you to take all administrative actions under your authority to 
come into compliance.
    As a result of my February 20 memorandum and your commitment to 
implement the Patient Bill of Rights, the Federal Government will be 
taking the lead in ensuring patient protections. By holding the Federal

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Government accountable, we are strengthening our call on the Congress to 
pass patient rights legislation that exceeds these protections to all 
Americans.
    Yesterday, in their report to me through the Vice President, the 
Quality Commission took the next logical step. Building on the Patient 
Bill of Rights, which is explicitly designed to ensure quality, the 
Commission's final report includes recommendations that I am confident 
will actually improve quality care. Specifically, the Commission called 
for the development of national health care quality improvement goals 
and the use of measurement standards that will empower consumers and 
businesses to make informed purchasing decisions based on health plans' 
quality performance records.
    The Quality Commission recommends establishing ``two complementary 
entities, one public and one private, to provide ongoing national 
leadership in health care quality improvement.'' The Commission 
recommends the creation of a broadly represented, publicly administered 
``Advisory Council for Health Care Quality'' and a privately 
administered ``Forum for Health Care Quality Measurement and 
Reporting.'' The Commission's approach represents a creative balance to 
achieve constructive involvement from all the parties that have 
important expertise and experience in this area.
    It is my strong belief that we must ensure that all relevant 
agencies within the Federal Government build on their leadership role in 
health care quality. As the Quality Commission report makes clear, the 
lack of coordination and uniform quality standards in both the public 
and private sectors has created conditions that fall ``short of fully 
meeting users' needs, and often are duplicative and unduly burdensome on 
health care providers, plans, and others.'' To that end, the Federal 
Government must use improved standards and goals to better inform and 
empower health care consumers and purchasers under Federal jurisdiction. 
Moreover, we must do a better job of collaborating within and across the 
Federal Government to most efficiently and effectively ensure we achieve 
the national goal of improving quality and health outcomes.
    Therefore, I am directing the Secretary of Health and Human Services 
to immediately establish a ``Quality Interagency Coordination'' (QuIC) 
task force to ensure better coordination among the executive agencies 
with jurisdiction over health programs. I hereby direct you to take the 
following actions consistent with your authority and the mission of your 
agency to meet or exceed the recommendations of the Quality Commission.

      First, I direct that all participating agencies shall have equal 
      standing on the QuIC task force.

      Second, I direct the task force to, wherever feasible, collaborate 
      on goals, models, and timetables that are consistent with the 
      Quality Commission's six ``National Aims for Improvement'': 
      reducing the underlying causes of illness, injury, and disability; 
      reducing health care errors; ensuring the appropriate use of 
      health care services; expanding research on effectiveness of 
      treatments; addressing oversupply and undersupply of health care 
      resources; and increasing patient participation in their care.

      Third, I direct the Secretary of Health and Human Services to 
      serve as the convener of the QuIC task force and to schedule the 
      first task force meeting to order by no later than March 27, 1998.

      Fourth, I direct the task force to improve cooperation by the 
      participating agencies on the development and utilization of 
      quality measurement mechanisms for public sector programs; these 
      efforts should be flexible enough to respond to changing needs, 
      technology, and information, while being sufficiently standardized 
      to be comparably measured.

      Fifth, I direct the task force to work to increase the development 
      and dissemination of evidence-based health care information to 
      help guide practitioners' actions in ways that will improve 
      quality and potentially constrain costs.

      Sixth, I direct the task force to consult with health care workers 
      and their representatives, as well as other affected

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      parties, in developing models for quality improvement.

      Seventh, I direct the task force to enhance efforts to develop 
      user-friendly information for both consumer and business 
      purchasers that facilitates meaningful comparisons of quality 
      performances of plans, facilities, and practitioners.

      Eighth, I direct all participating agencies, where feasible and 
      appropriate, to seek to avoid inefficient duplication of ongoing 
      quality improvement efforts and resources.

      Finally, I direct the task force, to every extent possible, to 
      endeavor to coordinate the Federal programs' quality reporting and 
      compliance requirements to reduce administrative burdens on 
      private entities who administer, oversee, or participate in the 
      Nation's Federal health programs.
                                            William J. Clinton