How Should We Measure Health Care Quality?

President Obama said Wednesday he has his pen in hand and is “ready to sign good bipartisan legislation” that will tie more payments for health care services to quality – not quantity – of services. The question is, says Scott Wallace, a leading authority on value-based delivery models, how do you define quality in health care delivery?

The push toward “pay for performance” isn’t new, but it is picking up speed as of late. As part of a “Big Issues” report prominently featuring Wallace, Wall Street Journal columnist Melinda Beck wrote, “Doctors and hospitals are being evaluated on myriad quality metrics by rating services, insurance companies, professional groups and government programs – with results increasingly tied to financial penalties or bonuses. But payers, providers and patients don’t always agree on what quality means, and there is no official set of standards.”

According to Wallace, a visiting professor at Dartmouth’s Geisel School of Medicine, quality needs to focus on the functional outcomes that matter most to patients. (For example, can a patient who had knee replacement surgery walk and climb steps?) Instead, current benchmarks are mostly centered on what is easiest to access and measure: processes.

Every person who helps deliver health care is accountable – to patients. But Wallace argues “no caregiver can possibly know whether the obligation to patients is being met without measuring the results of care.”

As the country transitions from paying for the volume of care to paying providers for the value of what they deliver, being able to consistently and accurately determine the quality of care is vitally important. Employers, health plans, government leaders and clinicians all need to orient around measuring the outcomes of care and whether health care restores and protects peoples’ capabilities.

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This is critical and challenging work, and it must be done carefully and fairly, urges Wallace. Ultimately, “the interests being served are those of patients, and improving their health is the purpose of health care.”

Join the debate by posting your comment to the Wall Street Journal article, “What Measures Should Be Used to Evaluate Health Care?

An accomplished adviser and masterful educator, Wallace combines his deep expertise with engaging style to offer distinct, world-class learning experiences – in speeches, in the classroom and through his highly customized Redefining Health Care workshops – that spur the meaningful discussion needed to develop new capabilities in health care delivery and build new frameworks for improving health outcomes.

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