Kenneth Kizer has been around the quality block more than a few times.
He directed the VA Health Care System during its metamorphosis; led the California health department during the early years of HIV, spearheaded a blunt anti-tobacco campaign that politicians tried to quash, and coined the term "never events."
Perhaps most significant, in 1999 this former emergency room physician founded and directed the National Quality Forum, an independent group of stakeholders who develop reliable, accurate ways for hospitals and other providers to measure, report, and improve quality. That's a tough set of issues from which to draw consensus.
Last Friday, the NQF became an even more significant player in healthcare reform. That's when the Obama Administration released the final rules for Value-Based Purchasing.
Set to take effect July 1, the rules establish specific measurements—nearly all of them researched and endorsed by the NQF—that will financially reward or penalize hospitals on the basis of care quality. With 1% or 2% of a hospital's entire Medicare DRG payments at stake in the coming years, quality now makes a business case for itself.
Moreover, next year there will be many more measures added, and more still the year after that.
Just before the VBP release, Kizer found some time for a telephone interview with me about where the quality field has been, and more importantly where it's headed.
"Now everyone is talking about measuring quality," he said, "But that wasn't how it was 11 or 12 years ago when I started NQF. No one really wanted to engage in measurement. Now, it's in a different place, but it clearly is not being used as much as it should be. There are many areas of medicine where there simply are no measures—or there are, but they aren't as good as they should be."