Catalyst for Payment Reform

For evidence based strategies, we need evidence!

For evidence based strategies, we need evidence!

By CPR’s Executive Director, Suzanne Delbanco

Long before there were agreed upon standards for measuring the quality of health care, any health care provider could measure its own quality and claim to be the best. I remember driving through a major northeast city and, on the same day, seeing billboards from competing hospitals both claiming to be the best at heart surgery.

Fortunately, we’ve come a long way with quality measurement.  While it’s still a work in progress, we have the National Quality Forum and countless contributors to its enterprise to thank for the fact that we now have standard ways to measure quality so that consumers can compare providers on equal terms and health care providers can know where they stand.

I often think about this evolution—a central part of my earlier career at The Leapfrog Group—as I face a similar challenge now.  There is no standard when it comes to evaluating the effectiveness of the various health care delivery and payment reforms being tried in health care today. As a result, most employers and other health care purchasers hear from their contracted health plans about the wins, but almost never about where health care quality or affordability has stayed the same or gotten worse.

We need standardization to get the full story—the good, the bad and the ugly.  How else can we, the customers, judge the value we are getting for our health care spending?  CPR created the Payment Reform Evaluation Framework for this purpose and we’re soon to launch a standard health plan ACO performance report for health plans to use in reporting the results of their ACO arrangements to purchaser customers.

Getting results in a standard fashion will help the industry build the evidence it needs to know which new health care delivery and payment approaches are working and in what context.  Without that, we’ll be on an endless experimentation loop where results, good or bad, can only be attributed to luck. Are you ready to stand with CPR to push for more and more rigorous evaluations? Read more about your role in the movement for greater evidence.

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