Measuring Value: Healthcare Metrics and Changing Definitions
Ask the average patient what they mean by quality care and they will say something like physicians who listen and take time with them in exam room. They may say something about the ambiance of the office, the friendliness of the nurse, or the skill of the surgeon.
These are not the metrics healthcare professionals talk about when they talk about PQRS, measuring value, or healthcare metrics. Measuring value is about control of chronic disease that is evidence based; evidence that can be trended and proven through data analysis. Measuring quality is an “eye of the beholder” thing with healthcare right now. The gap which exists between patient and provider in answer to what is quality care will take time to address and narrow. And providers will also need an adjustment period as well.
In the past, provider value was measured by how much money they made and the word of mouth testimonials of patients. Now value will be measured by carefully plotted data points that will demonstrate patient wellness. The value today is really about how well your practice can produce measurable data in a format and time frame it is being requested. It’s also about the overall structure in which the provider practices. If the practice environment does not have a well-run IT department and a decision-maker who understands how data is collected and reported the value will not be accurately generated and reported.
Whether an ACO, an enterprise hospital system, or a multi-practice system how to define the measurement of value should be incorporated in the fiber of the practice. There must be ongoing patient follow-up between visits to ensure the core values of wellness are being incorporated into daily routines. It’s about so much more now than patients compliantly taking meds. It’s about control of hypertension and diabetes that’s measurable daily. It’s about the use of mobile apps to communicate between patient and provider on a regular basis and not just an every three month. It’s about accurate data collection and reporting. A provider may be generating perfectly aligned value by the new definitions, but if that data is not collected and reported the value is worthless. IT has become not only the current buzz word of healthcare, but it is also the lifeline to reimbursement.
Measuring value is not new to healthcare. Value has always been compensated for, but the definition has changed and providers and practices must adjust their metrics to comply with the current value system.