The Value Dilemma

Today’s post first ran on Women of Impact on February 24.
The oft-used phrase, “from volume to value,” was coined here in Pittsburgh by our own Harold Miller as the title of a framing paper for our first of three Payment Reform summits. It clearly had resonance. I hear it in every venue where health reform advocates gather. “Value” is hot, and the Centers for Medicare & Medicaid Services (CMS) is moving rapidly to a value-based payment system in which provider payments are linked to quality and costs. Purchasers demand value. Accountable Care Organizations (ACOs) promise to deliver value.
But I am having trouble with value as the foundational North Star for all that we do in health care. Here’s why: It’s still very hard to measure quality in any comprehensive way. We can measure cost—that is, we could if health providers would make it public. However, when we went looking for the best “quality” hospitals in Pennsylvania so that we could better understand leadership in high-performing organizations, we hit a wall.
Surely, there are lots of rankings that purport to measure quality. But, using upwards of a dozen ranking measures, we discovered that there were almost no hospitals that scored high across the board. We analyzed CMS data on mortality, readmissions, hospital-acquired conditions, payment, and patient experience; Pennsylvania Health Care Cost Containment Council measures of mortality and readmissions; the Leapfrog Group’s hospital ...

Source: Disruptive Women in Health Care - March 3, 2016 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Health Reform Quality Source Type: blogs