The relationship between value based care and quality measurement

The relationship between value based care and quality measurement

The move toward value-based care for the independent physician requires data and time. A significant part of the challenge in value-based care is having the ability to measure quality quantitatively. The primary care physician must have a baseline from which to start and then must continue to have reliable data from which to measure that quality. All of that takes time, as does value-based care itself. Few medical interventions produce immediate results.

The Centers for Medicare & Medicaid Services (CMS) defines value-based care programs in terms of how they impact the physician caring for a Medicare patient: “Value-based programs reward health care providers with incentive payments for the quality of care they give to people with Medicare.” In addition, value-based programs support the “three-part aim” of CMS in terms of how that care impacts the patients themselves:

  • Better care for individuals
  • Better health for populations
  • Lower cost

Quality measurement also needs to reflect care that needs improvement. As Jason Goldwater, Senior Director at National Quality Forum, as quoted in EHR Intelligence, explains, “Not only should quality measurement give you information, but it should also should show you the pathway for what you need to do to make corrections if necessary or to continue to be consistent in delivering quality and efficient care that will continually meet those measures.”

Interoperability plays a key role in quality measurement as well, as it is necessary for the primary care physician to have reliable data available. Electronic health record (EHR) systems must have the ability to talk to each other, to enable the primary care provider to coordinate a patient’s care and to enable each healthcare provider caring for that patient to view the patient’s medical information. Data culled from those interactions then becomes part of the quality measurement process.