than a health plan is likely to be able to get on its own with the limited number of patients that it covers. There has been an added push for these efforts to do network or aggregated approaches to quality and cost measurement.

The practical relevance of this to the work that is being done in health accounts and price indexes is still a way off. However, McClellan pointed out that some of these broader measures are in the early stages of being constructed and made available. There is a broad national public-private roadmap planning effort to move from data that are based just on claims to data that include what might be called clinically enriched electronic information, like lab results and increasingly sophisticated information from electronic records or personal health records. There is a parallel between the kind of work that is going on here and the kind of work that is going on in the health accounts area.

McClellan expressed his concern that the initiatives he is involved with, as well as the overlapping health accounting programs, move forward as effectively as possible from a policy reform standpoint; this will require efficient use of data. Ideally, a virtuous cycle could be created in which, with more and better information available on outcomes and costs of care and therefore on the value of care, there will be a movement toward payment and benefit system designs that reward and support better value and clearer evidence about what actually works.

McClellan concluded his remarks by suggesting that some ongoing involvement of the BEA and the National Academies on work that is happening in these quality measurement, value measurement, and quality improvement efforts would make a lot of sense. The measurement goals across the various interests are similar; the only difference is that BEA has to focus on the national accounts as opposed to the actual impact on delivery of care.

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