[Public Papers of the Presidents of the United States: William J. Clinton (1998, Book I)]
[March 13, 1998]
[Pages 374-375]
[From the U.S. Government Publishing Office www.gpo.gov]

Memorandum on Establishment of the Quality Interagency Coordination Task 
March 13, 1998

Memorandum for the Secretary of Defense, the Secretary of Labor, the 
Secretary of Health and Human Services, the Secretary of Veterans 
Affairs, the Director of the Office of Personnel Management

Subject: Establishment of the Quality Interagency Coordination Task 

    Last November, I endorsed the ``Patient Bill of Rights'' recommended 
by the Advisory Commission on Consumer Protection and Quality in the 
Health Care Industry (the ``Quality Commission''). On February 20, 1998, 
after receiving your encouraging reports from the Vice President about 
the degree to which your agencies are in compliance with these rights, I 
directed you to take all administrative actions under your authority to 
come into compliance.
    As a result of my February 20 memorandum and your commitment to 
implement the Patient Bill of Rights, the Federal Government will be 
taking the lead in ensuring patient protections. By holding the Federal 
Government accountable, we are strengthening our call on the Congress to 
pass patient rights legislation that exceeds these protections to all 
    Yesterday, in their report to me through the Vice President, the 
Quality Commission took the next logical step. Building on the Patient 
Bill of Rights, which is explicitly designed to ensure quality, the 
Commission's final report includes

[[Page 375]]

recommendations that I am confident will actually improve quality care. 
Specifically, the Commission called for the development of national 
health care quality improvement goals and the use of measurement 
standards that will empower consumers and businesses to make informed 
purchasing decisions based on health plans' quality performance records.
    The Quality Commission recommends establishing ``two complementary 
entities, one public and one private, to provide ongoing national 
leadership in health care quality improvement.'' The Commission 
recommends the creation of a broadly represented, publicly administered 
``Advisory Council for Health Care Quality'' and a privately 
administered ``Forum for Health Care Quality Measurement and 
Reporting.'' The Commission's approach represents a creative balance to 
achieve constructive involvement from all the parties that have 
important expertise and experience in this area.
    It is my strong belief that we must ensure that all relevant 
agencies within the Federal Government build on their leadership role in 
health care quality. As the Quality Commission report makes clear, the 
lack of coordination and uniform quality standards in both the public 
and private sectors has created conditions that fall ``short of fully 
meeting users' needs, and often are duplicative and unduly burdensome on 
health care providers, plans, and others.'' To that end, the Federal 
Government must use improved standards and goals to better inform and 
empower health care consumers and purchasers under Federal jurisdiction. 
Moreover, we must do a better job of collaborating within and across the 
Federal Government to most efficiently and effectively ensure we achieve 
the national goal of improving quality and health outcomes.
    Therefore, I am directing the Secretary of Health and Human Services 
to immediately establish a ``Quality Interagency Coordination'' (QuIC) 
task force to ensure better coordination among the executive agencies 
with jurisdiction over health programs. I hereby direct you to take the 
following actions consistent with your authority and the mission of your 
agency to meet or exceed the recommendations of the Quality Commission.
    First, I direct that all participating agencies shall have equal 
standing on the QuIC task force.
    Second, I direct the task force to, wherever feasible, collaborate 
on goals, models, and timetables that are consistent with the Quality 
Commission's six ``National Aims for Improvement'': reducing the 
underlying causes of illness, injury, and disability; reducing health 
care errors; ensuring the appropriate use of health care services; 
expanding research on effectiveness of treatments; addressing oversupply 
and undersupply of health care resources; and increasing patient 
participation in their care.
    Third, I direct the Secretary of Health and Human Services to serve 
as the convener of the QuIC task force and to schedule the first task 
force meeting to order by no later than March 27, 1998.
    Fourth, I direct the task force to improve cooperation by the 
participating agencies on the development and utilization of quality 
measurement mechanisms for public sector programs; these efforts should 
be flexible enough to respond to changing needs, technology, and 
information, while being sufficiently standardized to be comparably 
    Fifth, I direct the task force to work to increase the development 
and dissemination of evidence-based health care information to help 
guide practitioners' actions in ways that will improve quality and 
potentially constrain costs.
    Sixth, I direct the task force to consult with health care workers 
and their representatives, as well as other affected parties, in 
developing models for quality improvement.
    Seventh, I direct the task force to enhance efforts to develop user-
friendly information for both consumer and business purchasers that 
facilitates meaningful comparisons of quality performances of plans, 
facilities, and practitioners.
    Eighth, I direct all participating agencies, where feasible and 
appropriate, to seek to avoid inefficient duplication of ongoing quality 
improvement efforts and resources.
    Finally, I direct the task force, to every extent possible, to 
endeavor to coordinate the Federal programs' quality reporting and 
compliance requirements to reduce administrative burdens on private 
entities who administer, oversee, or participate in the Nation's Federal 
health programs.

                                                      William J. Clinton