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A New Tool To Track The Progress Of The Health Care System



June 1st, 2012

Editor’s note: In addition to Sherry Glied, the Assistant Secretary for Planning and Evaluation (ASPE) at HHS, (photo and linked bio above), this post is coauthored by Erin Miller, a Public Health Analyst and Special Assistant to the ASPE, and Julia Spencer, Director of the Division of Science Policy, Office of Science and Data Policy, in the Office of the ASPE at HHS.

Now, thanks to a new tool launched by HHS, data about the state of the American health care system are at the fingertips of policymakers, providers and the public.  The Health System Measurement Project allows people to track the progress we are making toward providing all Americans with access to affordable, high-quality health care and toward reducing health disparities.

Gathering this information together in one place—and presenting it in a format that’s accessible and easy to navigate—not only makes data easier to understand, but it’s part of the Obama administration’s commitment to transparency and accountability.

The Project allows users to search for information on health care topics they’re interested in, and find regional or national-level data broken down by age, income level, and insurance coverage status. It focuses on ten critical dimensions of our health care system covering the availability, quality, and cost of care, the overall health of Americans, and the dynamism of the system. The Project also examines the evolution of these aspects of our system over time, and assesses the status of these dimensions of the system with respect to subgroups of the population, with a particular emphasis on vulnerable populations.

The Project was developed by a workgroup of experts drawn from across the Department.  The workgroup was charged with selecting a limited set of measures (a maximum of 50) that:

(1)    provides a broad overview of the health care system;

(2)    has established validity and reliability; and

(3)    can be displayed in a reasonably timely fashion.

The workgroup recognized that the greatest utility of the tool will be in drawing comparisons among populations, whether defined geographically, demographically, or socio-economically, and in highlighting the changing experience of these groups.  Therefore, the workgroup focused on measures that could be assessed at sub-group levels.  The Project is unique among similar scoreboards in providing a wide array of standardized breakdowns for almost every measure.

To reflect a broad range of health system outcomes, providers, and settings, the team found measures devoted to often-neglected areas — including  oral health service use, substance use screening follow-up, falls and pain in nursing homes, and innovation in the pharmaceutical and medical manufacturing sectors.

Another goal of the Project is standardizing and defining measures. For example, measures of out-of-pocket medical expenses sometimes include cost sharing and premiums, but sometimes include only cost sharing.  The Project uses the cost-sharing only measure as a measure of coverage quality, but separately includes a measure of premiums for employee-sponsored insurance as a measure of cost and affordability.  Another example of standardization is the decision to use the Current Population Survey (CPS) from the Census Bureau, rather than other HHS surveys, as the data source for health insurance coverage, since the CPS allows detailed coverage estimates for all states.

The workgroup also decided to include some novel measures in the Project.  For example, the National Center for Workforce Analysis developed a new measure of the size of the primary care workforce, including physicians, nurse practitioners, and physician assistants, which will now be updated annually.  Additionally, the National Center for Health Statistics worked with other Department researchers to develop a global measure of population health — expected years in good or better health without activity limitations — which is reported by age group, sex, and race.  While we plan to retain the 50-measure limit on the Project, we have left space for a few more new measures that can be added as new data become available.

Together with similar efforts like data.gov, the Health System Measurement Project is a step toward increasing accessibility of HHS data, enhancing government accountability, and making the U.S. health system more transparent.

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