A powerhouse group of business leaders claims there is no turning back to fee-for-service models. Specifically, they reject the notion that imperfect quality measures should delay the transition to value-based payment. In fact, they argue that using imperfect measures publicly forces rapid improvement in the methodology behind those measures and ultimately outcomes:
“For instance, New York State’s release of surgical mortality data for coronary artery bypass grafting (CABG) procedures jump-started the movement to define and more carefully collect much stronger measures of CABG outcomes, and today we have many advances in cardiac care and its measurement.”
The authors point to the use of patient safety indicators (PSIs), the appropriateness of which are frequently questioned by providers, as evidence that imperfect metrics can still improve quality outcomes when used properly and in context.
“The fact that there are rough spots on the road to value-based payment is hardly a justification for slowing down reform. If converting to a more sensible payment system were easy, it would have been done a long time ago.”
“Current quality measures may have rough edges, but stakeholders have worked hard to steadily improve their validity and reliability. Employers and other purchasers, such as those involved in our organizations, must work with forward-thinking colleagues in the healthcare system to continually improve the measures that publicly signal value.”
While the authors’ pragmatism is typical of industry stakeholders that come from business and payer organizations, they recognize the need to work closely with providers to smooth this long-term evolutionary processes.
A thorough, respectful process for building scientific and stakeholder consensus around measures has been orchestrated by leaders like the National Quality Forum (NQF) and the National Committee for Quality Assurance (NCQA). Purchasers are committed to partnering in the development and refinement of excellent measures while we advance transparency and payment reform alongside that work.
Their bottom line: “Returning to fee-for-service is not an option.”