Medicare (Title XVIII of the Social Security Act)
Health Care Quality Demonstration Program

Health Care Quality Demonstration Program329

The Secretary will establish a demonstration program under which she will approve demonstration projects that examine health delivery factors that encourage the delivery of improved quality in patient care,330 including: the provision of incentives to improve the safety of care provided to beneficiaries;331 reduced scientific uncertainty in the delivery of care through the examination of variations in the utilization and allocation of services, and outcomes measurement and research;332 encourage shared decision making between providers and patients;333 the provision of incentives for improving the quality and safety of care and achieving the efficient allocation of resources;334 and the appropriate use of culturally and ethnically sensitive health care delivery.335

To be eligible to participate in this program, an entity must meet quality standards established by the Secretary,336 including: the implementation of continuous quality improvement mechanisms that are aimed at integrating community-based support services, primary care, and referral care;337 the implementation of activities to increase the delivery of effective care to beneficiaries;338 encouraging patient participation in preference-based decisions;339 and the implementation of activities to encourage the coordination and integration of medical service delivery.340

In carrying out this program, the Secretary may direct the Director of the National Institutes of Health to expand the efforts of the Institutes to evaluate current medical technologies and improve the foundation for evidence-based practice;341 the Administrator of the Agency for Healthcare Research and Quality to, where possible and appropriate, use the program under this section as a laboratory for the study of quality improvement strategies and to evaluate, monitor, and disseminate information relevant to such program;342 and the Administrator of the Centers for Medicare and Medicaid Services and the Administrator of the Center for Medicare Choices to support linkages of relevant Medicare data to registry information from participating health care groups for the beneficiary populations served by the participating groups, for analysis supporting the purposes of the demonstration program, consistent with the applicable provisions of the Health Insurance Portability and Accountability Act of 1996.343