In 2013, the Centers for Medicare and Medicaid Services (CMS) kicked off a new initiative that was designed to improve healthcare quality nationwide while also cutting costs. Fed up with the problems inherent in the traditional fee for service model, CMS administrators unveiled valuable new incentives for healthcare providers to pursue.
These measures were designed to pave the way toward a more thorough transition to value-based purchasing, and it now seems that the movement will continue. As a result, hospitals and clinics all over the country are looking into how they can come up to speed themselves.
Three Cornerstones of Healthcare Value Assessment
Deciding how much value has been delivered by a particular course of treatment is, naturally enough, never a straightforward process. CMS has approached the problem by breaking things down into three separate areas that are to be analyzed on an organization-wide level in each case.
Healthcare providers that had sought to secure incentive payments for themselves will have already become familiar with these subjects. Others that are now trying to become compliant with value-based payment tracking requirements will need to be sure to pay attention to:
Healthcare quality. The most important measure in every case is how well an organization achieves the healthcare related goals set before it. Issues like hospital readmissions and deaths will detract from a facility’s quality metrics while positive outcomes add to them. Naturally enough, attention to such factors will rarely be entirely foreign to particular organizations, as they are normally considered important even under the traditional service-based fee model.
Best practices. Because the value of a given treatment will not always be amenable to encapsulation purely through analysis of outcomes, providers are also being encouraged to make adherence to best practices a top priority in every possible way. Adjusting to this standard will sometimes take more effort than will outcome-oriented encouragement of high quality healthcare delivery, in general.
Patient experiences. Finally, CMS also looks to the subjective reports of patients and their loved ones in making its determinations. In fact, studies have fairly consistently shown that satisfied patients tend to have received better care than others.
Making Steady Progress Should Always be the Goal
Just about every healthcare provider will need to make plenty of adjustments to live up to standards like these. In almost every case, simple determination and ongoing effort will make the difference.