the Quality of American Health Care
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There is no CME/CE credit awarded for this activity.
Release Date: April 14, 2008
Expiration Date: April 14, 2010
Physicians and pharmacists practicing in managed care setting and quality improvement
organizations; hospital administrators, nurses and medical technicians.
The Medicare Modernization Act (MMA) has provided an opportunity for quality
improvement organizations (QIOs) to partner with Medicare Part D plan sponsors,
pharmacists, physicians, and others.
To provide information about improving the quality of American health care through
the efforts of Quality Improvement Organizations, and to examine the emerging
interaction between QIOs and managed care pharmacy.
The U.S. spends far more on health care per person than any other nation.
If the current trend continues, 50 percent of the federal budget will
be consumed by the cost of Medicaid and Medicare by 2030. However, the
delivery of that care is not always correspondingly higher in comparison
with other nations. Across the U.S. the quality of care varies widely.
The difference between the care that scientific evidence recommends and
the care actually provided in practice is often referred to as the "quality
gap" in American health care.
The mission of QIOs, created by Congress in 1982, is to close the gap
by improving the quality and efficiency of services provided under the
Medicare program. QIOs are improving health care for Americans and effecting
cost reductions that can amount to billions of dollars, while using program
funding equal to less than one tenth of one percent of the Medicare budget.
A promising new partnership between QIOs and managed care pharmacy could
produce a significant advance in health care quality. Improved medication
therapy management in hospital and ambulatory settings is a key to major
improvements in health care.
A picture of the quality and efficiency of health care is emerging that is far
more complete than ever before compiled, using such varied sources as independently
abstracted hospital chart data, hospital self-reported data, claims data, plan
enrollment and utilization data and even consumer satisfaction data. QIOs are
helping health care providers assess their own performance, often leading to
a realization that there is need for improvement.
There are still persistent quality problems in the way drug therapy is organized
and delivered, resulting in preventable adverse drug events in hospital
David G. Schulke (Click on faculty name to view biography)
Executive Vice President
American Health Quality Association (AHQA)
Judith A. Cahill, CEBS (Click on faculty name to view biography)
Academy of Managed Care Pharmacy
This supplement was funded by a grant from Wyeth.
The presentation in this program was based on an AMCP, Journal of Managed Care Pharmacy (JMCP) supplement published in January 2008, in partnership with AHQA. The supplement was supported by a grant from Wyeth.
The content and views presented in this presentation are those of the faculty and do not necessarily represent the official policies or views of Wyeth.