Does meeting quality measures really improve patient outcomes?
That’s a critical question, since current pay-for-performance initiatives assume the answer is yes. For instance, does a higher percentage of hemoglobin A1c’s in diabetics really mean better patient outcomes?
Internist Robert Centor suggests otherwise, saying that there is very little data connecting the two. Extrapolating patients from studies to the real world is difficult, “as patients suffer more diseases, interpreting a performance measure on one disease must become more complex.”
Every reform plan wants to link payment to health outcomes. The problem is, the tools that are currently available are far too blunt to accurately achieve this goal.
topics: performance, centor
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- Does pay-for-performance work, and will it improve health care quality or patient outcomes?
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- What if P4P doesn’t improve outcomes?
- Does being on the America’s Best Hospitals list affect patient outcomes?
- Does paying for quality actually work?
- Are quality measures doing more harm than good?
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{ 3 comments }
Now I’m no expert, but wouldn’t the inclusion of performance evaluations add more to the bureaucratic processes already included within the system? If so, wouldn’t this translate into more costs, meaning higher insurance payments?
6:20,
Yes, it is bureaucratic masturbation. Now we have to make up “anti charting” to document why didn’t perform a certain measure.
“I did not give the CMS core measure beta blocker for this patient having an MI because he is in 3rd degree heart block with a rate of 35 and blood pressure of 70/40.”
Our hospital now has about hired about 3 PI nurses that do nothing all day but count these beans.
If you want to improve health outcomes lets spend more time on prevention. Only 30% of Americans with hypertension are aware they have it and of those who are hypertensive only 50% get it under control. This isn’ too complicated-practice medicine according to the guidelines determined by the NHLI and we’d be on our way.
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