Measuring outcomes and efficiency in medicare value-based purchasing.
The Medicare program may soon adopt value-based purchasing (VBP), in which hospitals could receive incentives that are conditional on meeting specified performance objectives. The authors advocate for a market-oriented framework and direct measures of system-level value that are focused on better outcomes and lower total cost of care. They present a multidimensional framework for measuring outcomes of care and a method to adjust incentive payments based on efficiency. Incremental reforms based on VBP could provoke transformational changes in total patient care by linking payments to value related to the whole patient experience, recognizing shared accountability among providers.
Tompkins
Christopher P
CP
Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA. tompkins@brandeis.edu
Higgins
Aparna R
AR
Ritter
Grant A
GA
D004059:Diffusion of Innovation; D017598:Efficiency, Organizational; D017754:Group Purchasing; D006801:Humans; D006278:Medicare / Q000191:economics / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D011785:Quality Assurance, Health Care / Q000191:economics / Q000592:standards*; D012052:Reimbursement, Incentive; D014481:United States