Tom Daschle former Senate majority leader, a Democrat from South Dakota,  and Michael Leavitt, former governor of Utah and Department of Health and Human Services Secretary under George W. Bush, agree the sheer volume of uncoordinated measures is overwhelming clinicians. Until these measures are narrowed down to the most important ones, and made uniform across all sectors of healthcare, the task of improving care will remain elusive, they say.

As opponents politically, at times, Daschle and Leavitt have the same goals in mind for healthcare: the transition to value-based care.

At the annual National Quality Forum conference in Washington, DC on Feb. 14, Daschle, who is now special policy advisor to the law firm of Alston & Bird joined Leavitt, now co-leader of the Nutrition and Physical Activity Initiative at the Bipartisan Policy Center, in a panel discussion to contend that the American healthcare system is making terrific headway, but more could be done to spur progress. Namely, the U.S. healthcare market needs to rally around a unified group of measures deemed to be most crucial.

“The dilemma we are having in driving quality measurement is we are still trying to fuss with the little gears,” Leavitt said. “We are going to have to discover the big gears and turn them. That’s all the consumer has interest in dealing with.”

An example of an effective big gear being used to measure healthcare quality today is the focus on readmission days. “As you spin this big gear, you will notice a lot of smaller gears also begin to spin,” he added.

Daschle hailed HITECH and the Affordable Care Act for laying down the important infrastructure for quality healthcare, but measurements are still in a state of chaos, he said. 

In the 15 years since the launch of the NQF, healthcare quality measurement has become more confusing than ever. “It’s the Wild West of today,” he said.

Providers are subjected to too many measures, with some 1367 for performance in use, all largely unaligned. Daschle predicts that as payment reform leans more and more toward value-based care “it could get even worse than it is today,” he warned.