■ Stop Medical Errors. Make Patients Safer. Save Lives

√ From the budget proposal, create a new payment system for hospitals and doctors under Medicare that rewards quality and efficiency, by bundling payment for episodes of care, improving hospital discharge planning, and denying payment for hospital re-admissions within 30 days due clearly to poor quality care. Estimated savings: $26 billion/10 years

√ Require public reporting of hospital acquired infections, which kill up to 100,000 people a year and cost the health care system $35-$45 billion extra to treat.

√ Adopt a version of the Institute of Medicine recommendation of ten years ago from To Err Is Human, to require public reporting of ‘never event’ medical errors (e.g., surgery on wrong site).

√ Adopt the Institute of Medicine recommendations for major improvements in the nation’s Emergency Response Systems: require coordination among ERs, tie Medicare capital payments for hospitals to adoption of ‘best practices’ in new ER construction.

■ Help Consumers Make Choices:

√ Create and fund an Office of Consumer Health Services in HHS that expands the State Health Insurance and Assistance Program and through grants to community based non-profit organizations provides consumers with information about general and specific insurance issues and policies, maintains an insurance information and complaint hotline, compiles federal and state data on insurance complaints, provides data on insurers’ quality, and ensures standardization of insurance definitions and forms.

√ In any new insurance ‘connector’ program, require ‘apple-to-apple’ comparisons so consumers can shop by quality and price between any combination of public and private insurers. Drastically reduce the number of small variations in insurance plans so consumers have meaningful choices.

√ Obtain savings by having insurers bid for the right to participate in any insurance connector program. Limit participants to a reasonable number of bidders who meet the criteria for cost and quality.

√ In any annual open enrollment periods, provide easy-to-use insurance price and quality comparison data.

■ Comparative Effectiveness Research (CER)

√ Create a permanent, all-payer CER trust fund similar to the provisions in the House-passed HR 3162 (110th Congress), with special attention given to identifying and reducing health disparities.

√ Expand existing AHRQ programs to disseminate the results of CER research to providers and consumers. Fund research into the “best practices” of disseminating such research and use CER data in easy-to-read ‘drug fact sheets’ on Rx labels.