UNION HOSPITAL HEALTH GROUP
Who Defines and Measures Quality?

There are a great many organizations and governmental bodies that measure data, provide national benchmarks, and help to shape the definition of quality health care in the United States. Popular examples include:

United States Department of Health and Human Services
The U.S. Department of Health and Human Services (HHS) is the main governmental agency to which many well-known organizations report. For example, the following organizations are under the HHS umbrella: CMS or Medicare, the Food and Drug Administration (FDA), National Institutes of Health (NIH), Centers for Disease Control Prevention (CDC) and more.

The United States Department of Health and Human Services is the main agency for protecting the health of all Americans and providing essential human services to the general population.

Centers for Medicare & Medicaid Services (CMS)
The Centers for Medicare & Medicaid Services, often referred to simply as CMS or Medicare, is the governmental health care payor for qualifying seniors and lower-income families. CMS provides reimbursement for health care charges and sets the reimbursement benchmark for other payors, such as insurance companies. CMS also works with the Department of Health and Human Services to set governmental health care policies and quality standards. Recently, CMS developed several quality improvement efforts. For example, CMS now requires hospitals to report data on several key factors, including measures for treatment of heart attack, heart failure, pneumonia and surgery. Union Hospital's indicators are highlighted in Our Quality Outcomes section.

The National Committee for Quality Assurance (NCQA)
The NCQA is a nonprofit organization with a mission to improve national health care standards. The organization provides details to evaluate health care plans and network physicians. NCQA developed the Health Plan Employer Data and Information Set (HEDIS ® ) with standardized performance measures to assess health plans. HEDIS scores can be used to evaluate health plans and individual physicians within the plans. NCQA also developed a health plan report card to ease the health plan evaluation process for consumers.

Health Plan Data and Information Set (HEDIS®)
HEDIS is a set of standardized performance measures to assess health plans and physician groups. HEDIS measures were developed by the National Committee for Quality Assurance (NCQA), a nonprofit organization whose mission is to improve national health care standards. Consumers will begin to see these measure from their health care insurance companies. Union Hospital's indicators are highlighted in Our Quality Outcomes section.

About the Healthcare Facilities Accreditation Program (HFAP)
The Healthcare Facilities Accreditation Program (HFAP) of the American Osteopathic Association has been providing medical facilities with an objective review of their services since 1945. The program is recognized nationally by the federal government, state governments, insurance carriers and managed care organizations. Union Hospital Health Group is accredited through HFAP.

It is one of only two voluntary accreditation programs in the United States authorized by the Centers for Medicare & Medicaid Services (CMS), formerly HCFA, to survey hospitals under Medicare. In addition, the program is a cost effective, user friendly means to validate the quality of care provided by a facility.

Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
JCAHO, also commonly referred to as Joint Commission, provides accreditation to hospitals that meet a certain baseline of quality standards. JCAHO's mission is to improve the safety and quality of care provided through certified accreditation and related services that support improvement in health care organizations, especially hospitals. The Joint Commission is a nonprofit organization that evaluates and accredits more than 15,000 health care organizations and programs in the United States. While UHHG does not use JCAHO as its accrediting body, UHHG implements JCAHO guidelines recommended in its Sentinel Event Alerts.

HealthGrades
HealthGrades Inc. is a for-profit health care ratings, data and advisory company. HealthGrades provides customers with solutions to measure and assess health care quality by market area. General hospital information is provided to consumers for free; however, in-depth reports are available for order.

The Leapfrog Group
The Leapfrog Group is an initiative focused on driving breakthrough improvements in quality, affordability and especially safety in health care. The initial focus of The Leapfrog Group is to improve patient safety by reducing preventable medical mistakes.

National Quality Forum (NQF)
A private, nonprofit membership organization, the National Quality Forum was created to improve U.S. health care through establishment of national standards for measurement and reporting on safe, timely, beneficial, efficient, equitable, patient-centered care. The NQF has members from all aspects of health care, including national, state and regional groups that represent consumers and the general health care system of health plans, hospitals and supporting industries and organizations. The NQF board of directors includes members from two key federal agencies, CMS (Medicare) and the Agency for Health Care Research and Quality. NQF votes to endorse quality measures for national use and develops a research agenda for quality improvement.

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