The top
executive of the country’s premier health care quality organization is
resigning from the boards of two health care companies amid questions about the
ethics of the relationships.
As
ProPublica reported, Dr. Christine Cassel has
earned six-figure compensation from the companies, which have an interest in National
Quality Forum endorsements that influence practices adopted by medical providers across the
country.
The Quality Forum said in a
statement today that Cassel’s decision to sever ties was voluntary.
“Although serving on these boards
provided her with direct knowledge of many current issues in health care, as
well as practices of good governance, the issue of her board involvement had
become a distraction,” the organization said in a prepared statement.
Cassel was hired in late 2012 to
lead the nonprofit Quality Forum, which gets the bulk of its money from a
contract with the Centers for Medicare & Medicaid Services (CMS).
ProPublica reported that Cassel
was paid about $235,000 in compensation and stock last year as a director for
Premier, Inc., a North Carolina purchasing and consulting company. She has been
a longtime director for Kaiser Foundation Health Plans and Hospitals. Kaiser
officials said she was paid $203,500 in 2012, the most recent year available.
Ethics experts said Cassel’s outside
involvement presented clear conflicts of interest that were best eliminated if she
resigned from the directorships. The Quality Forum said that Cassel’s ties had
been disclosed and were approved after a legal review when she was hired.
“Chris Cassel has shown tremendous
leadership in voluntarily stepping down from these important board seats. Her
generous act demonstrates her strong and continued commitment to NQF and its
mission,” Helen Darling, chairwoman of the NQF board, said in the statement.
The Quality Forum’s more
than 700 endorsed measures cover everything from tracking hospital readmissions
to setting information technology standards. Some are recommended to Medicare
for use as “pay for performance” measures that tie reimbursements to quality.
A Quality Forum endorsement is
considered the gold standard for health care practices. But questions arose in
January when it became public that the co-chair of a committee endorsing
patient safety measures accepted $11.6 million in undisclosed contracts from a
drug company.
The Justice Department, which
disclosed the payments in settling a whistleblower lawsuit, said the contracts
were meant to win the Quality Forum’s endorsement for one of the company’s
antiseptic products.
The Quality Forum said its 2010 Safe Practices guidelines did not include an endorsement
of the product, called ChloraPrep. But a review by ProPublica showed that, in fact, they did endorse ChloraPrep’s
formula. Afterward, the Quality Forum announced a review the Safe Practices endorsements
and its conflict-of-interest policies.
The findings from that review are
expected to be announced Friday.
Cassel has declined interview
requests. Earlier this month, Darling said she believed it was an asset to have
Cassel aligned with such prominent organizations like Kaiser and Premier.
“It’s like saying you’ve got a Ph.D. from Harvard,” Darling said.
“This is something you’d be proud of.”
Darling added that Cassel is
well-compensated by Quality Forum, where her annual salary is $561,000, and said
it was unreasonable to suggest she would be influenced by money.
“She is a strong person,
and she has very strong principles,” Darling said.
Eric Campbell, an expert in
conflicts-of-interest at the Harvard School of Medicine, called Cassel’s decision
to step down from the outside boards a good one that
shouldn’t be perceived as an admission of wrongdoing.
Lisa McGiffert,
executive director of Consumer Union’s Safe Patient Project, is a Quality Forum
member who questioned Cassel’s outside board roles with Kaiser and Premier. She
also said resigning was the right thing to do.
“If she was going to continue at
the National Quality Forum, she needed to separate herself from those other
responsibilities,” McGiffert said.
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