HCFA's health care quality improvement program and the cooperative cardiovascular project

The Health Care Financing Administration (HCFA) is changing the direction of its quality assessment and improvement program from one that tries to identify and cull "bad apples" to one that tries to improve the mainstream of care. This strategy change is known as the "Health Care Quality Improvement Program." An important aspect of this strategy change is to develop a partnership with providers that will ensure the provision of quality improvement information that is valid and useful to them. The Health Care Quality Improvement Program consists of both quality improvement projects and a series of quality indicators. The Medicare Quality Indicator System will develop a small number of indicators or appropriateness criteria for each major medical condition that affects Medicare beneficiaries. This national monitoring system has 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 appropriate to carry out quality-of-care improvement projects; and (3) to support the execution of these projects. Quality improvement projects are cooperative efforts designed to improve a specific aspect of care. The Cooperative Cardiovascular Project is an early quality improvement project focusing initially on acute myocardial infarction; it will later focus on coronary artery bypass grafting and percutaneous coronary artery angioplasty.