June 26,2013

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Hatch Statement at Finance Committee Hearing Evaluating Efforts to Advance High Quality Healthcare in America

WASHINGTON – U.S. Senator Orrin Hatch (R-Utah), Ranking Member of the Senate Finance Committee, delivered the following opening statement at a committee hearing evaluating efforts to advance high quality healthcare in America:

I’m pleased that we’re having a series of hearings addressing different parts of our healthcare system.
Last week’s hearing showed us that transparency goes beyond price to include quality as well.  Indeed, the price-quality equation should help us determine the value of our healthcare.  
Currently there is so much marketing around provider quality, particularly with regard to hospitals.  

Everyone seems to be claiming to be the best at something.  Many of these claims are based on proprietary data, making it hard for consumers to have an accurate picture of our healthcare system.  

Perhaps quality is in the eye of the beholder.

I hope that today’s hearing will help us to better understand another very important part of our healthcare system.  For years, providers, payers, and federal programs have been consumed with measuring quality with an eye towards altering the payment system to reward better quality care.

I understand how complicated it can be.
My concern is that the system as it currently stands seems quite unorganized, focusing on far too many things.  We need to be very mindful that the primary purpose of quality measurement is to promote quality improvement.

To be clear, I think a focus on measurement is the appropriate first step in building a solid foundation for quality.  However, I wonder whether we have the right tools in place to help clinicians learn how to improve, rather than simply showing them how they compare to their peers.

Assessing a starting point is important, but ultimately the goal should be to improve care for every patient and that means giving clinicians the necessary resources in terms of best practices and care management.

It also means providing clinicians with clear and consistent definitions of clinical concepts.  If our collective goal is to ensure that every patient receives the right care, in the right place, and at the right time, providers need to know how those are defined and determined.

Because data will be determined by measurement, it’s imperative that we get measurement right in first place.  

Providers should have confidence in the data being used to assess their care and the payment for that care.

In addition, we need to remember that the job of a clinician is to provide care to patients, not spend an unreasonable part of their day inputting data for measurement purposes.   

It seems to me that, in order for quality programs to be successful, the collection of data needs to be as streamlined as possible and simply be an outgrowth of routine clinician workflow.

I have the good fortune to represent a state with some of the highest quality healthcare providers in the nation.  They are constantly striving to do better, and I commend them for that.  However, I am aware that some providers in this country are struggling to make improvements.  
I think we need to understand and appreciate that resources vary greatly across this country and this has an impact on quality data.  Sometimes quality scores might not truly reflect the care being given at an institution.  

But, I want to be clear about this – efficient and high-quality care must be an expectation that we have, not merely a goal.   And we cannot accept providers not making quality a top priority.

Our witnesses this morning will share with us all of the activities going on in the quality space today, both in the Medicare and Medicaid programs, as well as the private sector.  With so much at stake, and so many taxpayer dollars going into various reporting initiatives, I would encourage all of us to work together to ensure that the process is well thought out, streamlined, and moves us towards improving outcomes in care, which is the ultimate goal.

And so, Chairman Baucus, thank you, once again, for convening this hearing today and I look forward to hearing from our witnesses and learning about our collective progress in advancing high quality health care in this country.