Parsing Volume to Value, Proxy Measures, and the Streetlight Effect

Despite some concern that the migration from fee-for-service to value based payment (VBP) is being reversed, there remains strong momentum for VBP – both nationally – in the form of the bipartisan 21st Century Cures Act that was passed and signed into law last December, and many state and commercial initiatives, including the one I’m personally involved with, New York Delivery System Reform Incentive Payment Program (DSRIP).  Defining value, of course, is not easy.  I’ve often returned to Michael Porter’s short essay on this topic when I feel my definition meandering. Go read it now.  Please. Ok, you’re back?  Cool.  That was good, eh?  I love the last paragraph: The failure to prioritize value improvement in health care delivery and to measure value has slowed innovation, led to ill-advised cost containment, and encouraged micromanagement of physicians’ practices, which imposes substantial costs of its own. Measuring value will also permit reform of the reimbursement system so that it rewards value by providing bundled payments covering the full care cycle or, for chronic conditions, covering periods of a year or more. Aligning reimbursement with value in this way rewards providers for efficiency in achieving good outcomes while creating accountability for substandard care. As CEO of Alliance for Better Health, I’ve been working with care delivery organizations in our community to navigate the path forward.  They clearly...
Source: Docnotes - Category: Primary Care Authors: Tags: Technology Value Source Type: blogs