HCFAS HEALTH-CARE QUALITY IMPROVEMENT PROGRAM AND THE COOPERATIVE CARDIOVASCULAR PROJECT

The Health Care Financing Administration (HCFA) is changing the direct ion of its quality assessment and improvement program from one that tr ies to identify and cull ''bad apples'' to one that tries to improve t he mainstream of care. This strategy change is known as the ''Health C are Quality Improvement Program.'' An important aspect of this strateg y change is to develop a partnership with providers that will ensure t he provision of quality improvement information that is valid and usef ul to them. The Health Care Quality Improvement Program consists of bo th quality improvement projects and a series of quality indicators. Th e Medicare Quality Indicator System will develop a small number of ind icators or appropriateness criteria for each major medical condition t hat affects Medicare beneficiaries. This national monitoring system ha s three primary goals: (1) to track trends in the quality of care over time and in variations in the quality of care across regions; (2) to provide the basis for making decisions on where it would be appropriat e to carry out quality-of-care improvement projects; and (3) to suppor t the execution of these projects. Quality improvement projects are co operative efforts designed to improve a specific aspect of care. The C ooperative Cardiovascular Project is an early quality improvement proj ect focusing initially on acute myocardial infarction; it will later f ocus on coronary artery bypass grafting and percutaneous coronary arte ry angioplasty.