The Quality and Cost Council held its April meeting today. The Council approved sending out a job offer letter to Katharine London for Executive Director. The Council reviewed proposed by-law changes which, in a nutshell, include a new section regarding the duties of the new Executive Director (including the ability to hire additional employees); a new section allowing the Council to hold executive sessions (but not take any action or make any decision during such session) by majority votes; and a section regarding the rewarding of contracts.
There was much discussion about the executive session proposal. Dolores Mitchell was concerned the wording would allow an executive session to be called for any purpose and said transparency is better, as transparency is a key Council goal. Others felt executive sessions allow for fuller discussion and some individuals would not say certain things in a public setting. Most felt requiring majority vote to move to executive session would limit the number of times such sessions are called. The section was left in the by-laws, with the majority vote requirement.
The Council reviewed an outline of potential levers and methods the Council can use to improve quality, cost and racial/ethnic health disparities. Some items were drawn from discussions in the Council’s cost and quality subcommittees and some were drawn from elsewhere (i.e.: cost control recommendations submitted by organizations to the cost subcommittee).
The outline is not final, and we invite you to look over the matrix (PDF) and send us your comments. We will share your comments through our seat on the Council’s advisory committee. The matrix includes the following levers to influence change:
1. Patient Choice (educating and/or providing incentives to patients to choose low cost and high quality care);
2. Malpractice (regulation or legislation to reduce cost and possibly impact quality);
3. Capacity (addressing over and underutilization of health care services);
4. Payment Systems;
5. Clinical Decision Making (e-prescribing and other technologies to decrease or eliminate hospital infections); and
6. Promoting Prevention and Chronic Disease Management.
We hope the Council will align and advance quality improvement and cost containment efforts taking place in all of these areas.
At the same time, we contrast the Councils efforts with the dramatic progress and speed achieved over the past year on the health care access parts of Chapter 58. We see how the Quality and Cost Council has yet to get in gear. It’s too bad the same sense of urgency and purpose that has characterized the great work on the access side has not been evident as well in quality and costs.