Promoting Quality and Efficient Health Care in Federal Government Administered or Sponsored Health Care Programs

This executive order directs federal agencies administering health care programs (FEHBP, Medicare, IHS, TRICARE, VA) to adopt interoperable health information technology systems, implement quality measurement and price transparency programs, and promote quality and efficiency through pay-for-performance and consumer-directed options. All requirements must be complied with by January 1, 2007, without additional federal spending.

Federal Register Open PDF 71 FR 51089

Impact dates

Jan 1, 2007
Agencies shall comply with all requirements of this order

Key directives

Agencies shall use health IT systems meeting recognized interoperability standards when implementing, acquiring, or upgrading systems
Agencies shall require contractors (providers, plans, issuers) to use interoperable health IT systems
Agencies shall implement quality measurement programs based on multi-stakeholder standards
Agencies shall make pricing information available to beneficiaries/enrollees
Agencies shall develop pay-for-performance and consumer-directed health care approaches
All compliance by January 1, 2007

Who is ordered

Secretary of Health and Human Services · Department of Health and Human Services

Timeline

Immediate

EO issued August 22, 2006

Near term (90d)

Agencies must comply with all requirements by January 1, 2007 (131 days)

Long term

Implementation in new contracts or contract cycles as renewed
Ongoing quality measurement and price transparency programs

Risks & tensions

Zero-additional-cost constraint (Sec. 5(a)) may limit implementation speed and scope
Implementation tied to normal contract cycles may delay actual changes for months or years
Medicaid and SCHIP explicitly excluded, creating potential coverage gaps
Interoperability standards 'recognized by the Secretary' were still developing in 2006, creating uncertainty about what systems would qualify
No private right of action (Sec. 5(c)) limits enforcement to internal/administrative pressure