Policy makers and stakeholders have examined the U.S. healthcare system thoroughly in light of the urgent concerns over compromised patient safety
Policy makers and stakeholders have examined the U.S. healthcare system thoroughly in light of the urgent concerns over compromised patient safety, rising prices, and an increase in the number of uninsured and underinsured people. It should be noted that through my professional interactions and in-depth research, I’ve come to realize that three core strategies, public reporting, performance assessment, and value-based payment, are crucial to advancing a high-value healthcare agenda.
A key component of this agenda is public reporting, which gives patients and families access to clear information on the standard of care and patient safety. This openness encourages thoughtful decision-making and holds healthcare professionals responsible for the care they offer. Studies like the one that was published in the Journal of General Internal Medicine in 2019 show that patient outcomes and death rates improve when hospital quality measurements are made publicly available.
In order to assess and improve the quality of care, performance measurement is essential. Healthcare systems find opportunities for improvement and put in place focused quality improvement programs by monitoring outcomes, adherence to standards, and patient satisfaction. Performance assessment has the ability to spur quality improvements across the board in healthcare, according to the Institute of Medicine paper “Crossing the Quality Chasm” (Ladebue et al., 2016).
It should be noted that Value-based payment methods, like pay-for-performance, bundled payments, and episode-based payments, encourage the provision of high-quality care at a reasonable cost. New England Journal of Medicine research published in 2018 shows that value-based payment models result in better patient outcomes, fewer hospital readmissions, and lower overall expenditures. The impact of healthcare payment and delivery mechanisms on the standard of care is complex. Different payment models influence different provider behaviors. For example, fee-for-service models may unintentionally promote unneeded treatments, whereas capitation models may encourage preventive care initiatives. According to a 2016 study published in the Journal of General Internal Medicine, capitation models promote higher use of preventative treatment (Totten et al., 2012).
Care coordination and delivery efficacy are influenced by delivery types as well. Due to their holistic approach, primary care-based models thrive in coordinating care because primary care providers maintain thorough oversight and communication with other providers. The crucial importance of primary care in attaining seamless care coordination is stressed in the National Academy of Medicine study “Primary Care: America’s Health in a New Era.” Additionally, models of care delivery based on research consistently show better results. According to a 2015 study featured in JAMA Internal Medicine, healthcare models founded on the most recent scientific research result in better patient outcomes and increased effectiveness (Adair et al., 2006).
Adair, C. E., Simpson, E., Casebeer, A. L., Birdsell, J. M., Hayden, K. A., & Lewis, S. (2006). Performance measurement in healthcare: part I–concepts and trends from a state of the science review. Healthcare Policy, 1(4), 85.
Ladebue, A. C., Helfrich, C. D., Gerdes, Z. T., Fihn, S. D., Nelson, K. M., & Sayre, G. G. (2016). The experience of patient aligned care team (PACT) members. Health care management review, 41(1), 2-10.
Totten, A., Wagner, J., Tiwari, A., O’Haire, C., Griffin, J., & Walker, M. (2012). Public reporting as a quality improvement strategy. Closing the Quality Gap: Revisiting the State of the Science. Rockville: Agency for Healthcare Research and Quality.
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