U.S. health care spending is expected to jump more than $2 trillion — 62.8 percent — in the next nine years, according to Medicare actuaries. Policymakers are faced with finding the happy medium between the ability to measure outcomes and not overburden providers, a recent article in Healthcare Informatics says.
The Centers for Medicare & Medicaid Services (CMS) is already addressing the shift through its Meaningful Measures initiative. The approach, “will involve only assessing those core issues that are most vital to providing high-quality care and improving patient outcomes. The agency aims to focus on outcome-based measures going forward, as opposed to trying to micromanage processes,” CMS said in a statement last fall.
While finding the balance in quality measures is a concept that has been steadily gaining speed in the last 10 years or so, the real issue at heart is how to achieve alignment on those measures. The problem speaks to what Jeff Smith, vice president of public policy for the American Medical Informatics Association, has identified as a much larger issue in medicine: defining what value is among different physicians.
Similarly, it will take payers and providers working together to determine a common set of measures, a task that has proven difficult given the lack of shared financial risk between the two.
“For instance, if a payer is assuming all the financial risk in a given value-based contract, its goals will be different than the provider that is in that agreement,” the article states.