This year’s National Healthcare Quality and Disparities Report and National Quality Strategy Update have been integrated into this single document that describes the nation’s progress in improving health care access, quality, and disparities.
Key findings from this year’s report include:
- Access to health care has improved dramatically, led by sustained reductions in the number of Americans without health insurance and increases in the number of Americans with a usual source of medical care.
- Quality of health care continues to improve, but wide variation exists across the National Quality Strategy priorities.
- Effective Treatment measures indicate success at both improving overall performance and reducing disparities.
- Care Coordination measures have lagged behind other priorities in overall performance.
- Patient Safety, Person-Centered Care, and Healthy Living measures have improved overall but few disparities have been reduced.
- Care Affordability measures are limited for summarizing performance and disparities.
- Disparities related to race and socioeconomic status persist among measures of access and all National Quality Strategy priorities, but progress is being made in some areas. Disparities in quality of care and disparities in access to care typically follow the same pattern, although disparities in access tend to be more common than disparities in quality.
As health care delivery continues to evolve, the framework of the National Quality Strategy and the tracking of the National Healthcare Quality and Disparities Report can help identify system successes that should be celebrated as well as aspects of the system that require attention. While most measures of health care quality can only be tracked through 2013 and therefore are insufficient for assessing trends following the major coverage expansions of the Affordable Care Act, these reports establish the baseline against which to track progress in future years.
For the first time, this year’s National Healthcare Quality and Disparities Report and National Quality Strategy Update is a joint effort addressing the progress made against the National Quality Strategy priorities at the 5-year anniversary of the Strategy. The National Quality Strategy is backed by the National Healthcare Quality and Disparities Report data. Integration of these two efforts within the Agency for Healthcare Research and Quality (AHRQ) supports the development of this more comprehensive report on the success of efforts to achieve better health and health care and reduce disparities.
About the National Healthcare Quality and Disparities Report
For the 13th year in a row, AHRQ has reported on health care quality and disparities. The annual National Healthcare Quality and Disparities Report (QDR) provides a comprehensive overview of the quality of health care received by the general U.S. population and disparities in care experienced by different racial, ethnic, and socioeconomic groups. The report measures trends in several dimensions of quality, including effectiveness of care, patient safety, timeliness of care, patient centeredness, and efficiency of care. On a rolling basis, the report presents, in a chart form referred to as "Chartbooks," the latest available findings on quality of and access to health care as they become available.
The report assesses the performance of our health care system and identifies areas of strengths and weaknesses, as well as disparities, along three main axes: access to health care, quality of health care, and priorities of the National Quality Strategy. The report is based on more than 250 measures of quality and disparities covering a broad array of health care services and settings. The reports are produced with the help of an Interagency Workgroup led by AHRQ.
About the National Quality Strategy
The Patient Protection and Affordable Care Act mandated the establishment of a National Strategy for Quality Improvement in Health Care (the National Quality Strategy, or NQS), as part of the goal of increasing access to high-quality, affordable health care for all Americans. The National Quality Strategy pursues three broad aims (better care, healthy people/healthy communities, and affordable care), supported by six priorities (making care safer; person- and family-centered care; effective communication and care coordination; prevention and treatment of leading causes of morbidity and mortality; health and well-being of communities; and making quality care more affordable). The National Quality Strategy is foundational for the U.S. Department of Health and Human Services’ broader efforts to help move the health care system to one that achieves the goals of better care, smarter spending, and healthier people.
This year marks the 5-year anniversary of the National Quality Strategy, which was developed through a transparent and collaborative process with input from a range of stakeholders, representing all sectors of the health care industry and the general public. The National Quality Strategy serves as a guide for identifying and prioritizing quality improvement efforts, sharing lessons learned, and measuring the collective success of Federal, State, and private-sector health care stakeholders across the country.
Five years later, diverse stakeholders, including federal agencies, community health organizations, and commercial companies are working together in new and innovative ways to make the National Quality Strategy part of their day-to-day efforts to make health and health care better and more affordable for people and communities. At the federal level, the Strategy’s aims (better care, healthy people/healthy communities, and affordable care) and six priorities (making care safer; person- and family-centered care; effective communication and care coordination; prevention and treatment of leading causes of morbidity and mortality; health and well-being of communities; and making quality care more affordable) have paved the way for the U.S. Department of Health and Human Services’ operating divisions, along with the U.S. Office of Personnel Management, to incorporate the Strategy into their quality improvement activities.
Rationale for Integration
In the 5 years since the National Quality Strategy was released, health care in America has undergone many changes. As a result of the Affordable Care Act, 20 million adult Americans have obtained health insurance from 2011 to 2016, including 8.9 million White, 4 million Hispanic, and 3 million Black adults ages 18-64 from the start of open enrollment in October 2013 through early 2016.1
As more Americans continue to obtain health insurance and use health care services, achievement of the National Quality Strategy aims of better, more affordable care for individuals and the community increasingly demands a focus on maintaining increased access to care and reducing health disparities that lead to unequal health outcomes. In this dynamic health care environment, the National Quality Strategy and National Healthcare Quality and Disparities Report play complementary roles in improving health and health care quality for all Americans.
The National Quality Strategy highlights progress made on the Strategy’s six priorities and notes which priorities show significant improvements and which merit more attention. The annual National Healthcare Quality and Disparities Report was designed specifically to detect changes in health care access, quality, and disparities and can track progress made for each of the National Quality Strategy priorities.
Organization of Integrated Report
This integrated report presents information on trends, disparities, changes in disparities over time, and initiatives across the country demonstrating innovative quality improvement programs. The following sections are:
- Aims of the National Quality Strategy that describes quality improvement goals for the Nation.
- Access and Disparities in Access to Health Care that tracks progress on making health care available to all Americans.
- Quality and Disparities in Quality of Health Care that tracks progress on ensuring that all Americans receive appropriate, safe, timely, and person-centered services.
- Priorities of the National Quality Strategy that tracks progress on each priority and identifies promising practices for each priority.
- Looking Forward that summarizes future directions for health care quality initiatives.