CSG Webinar: Value Over Volume: Paying for Quality. March 28, 2012
Dr. Ellen Andrews, expert speaker on the March 28 CSG health policy webinar “Value Over Volume: Paying for Quality,” urged state policymakers to be brave as they implement payment reforms that depend on the right incentives to achieve better health outcomes. She suggested to webinar attendees that the time is right for transforming delivery and payment systems–- regardless of the findings of the Supreme Court on the Affordable Care Act–-because the status quo is simply not sustainable.
Andrews built the case for reform by reviewing sobering comparative data. Compared to other nations, the U.S. is not getting more years of life from its significantly higher health care spending. On average, Americans get only 55 percent of recommended care. One in three Americans report getting unnecessary care or duplicate tests.
Implementing quality-based purchasing, according to Andrews, does the following:
- Rewards better outcomes
- Bases payments on value -- quality balanced with cost
- Is driven by data
- Removes incentives for more services
- Rewards providing the right services to the right patient at the right time in the most effective setting
- Allows flexibility for providers to customize care
- Rewards patient satisfaction
- Removes fragmentation and conflicting incentives
- Aligns provider, payer and consumer incentives to reward quality, effectiveness and efficiency
Andrews discussed how state policies can support payment reform, how state governments can partner with other health care payors in moving forward on payment reform, and what opportunities are provided in the Affordable Care Act for states to tackle this system change. She also shared state examples of payment reform as well as successful federal Medicare initiatives.
Andrews is the coordinator of the multi-state Health Policy Steering Committee for CSG East as well as executive director of the Connecticut Health Policy Project and instructor at Yale University’s medical and nursing schools.
CSG East formed a special health committee to engage in a multi-year project to consider new initiatives to link health care purchasing to quality. The committee collected lessons learned from stakeholders engaged in quality-based purchasing and developed guiding principles for states embarking on such initiatives. Information on the lessons learned and guiding principles are available at a website devoted to this CSG work: www.valueovervolume.org.
Value Over Volume: Paying for Quality