Reimagining A Quality Information System For US Health Care
by David Lansky – HealthAffairs 1/25/2022
David Lansky, PhD is a senior advisor to and former President & CEO of the Purchaser Business Group on Health (formerly the Pacific Business Group on Health)
It’s time for a wholesale replacement of our system for measuring health care quality and putting quality information to use. The current retrospective, transactional system for measuring and rewarding improvement is ineffective, expensive, burdensome, no longer credible, and does not measure health or the outcomes of health care.
Thirty years after the widespread adoption of managed care models and the general reporting of HEDIS and CAHPS measures, we still evaluate health care quality based on administrative claims data, office and hospital-based care modalities, and a transactional view of health care payment and delivery. And 10 years since the implementation of “meaningful use” and the launch of the Center for Medicare and Medicaid Innovation (the Innovation Center) alternative payment models, we still don’t know if our innovations have led to better health or improved value.
To achieve value-based care, and to ensure that care is more patient-focused, we need profound changes in how we capture and apply information about quality of care and health outcomes. Such change requires a commitment from policy makers and industry leaders to pursue:
- a national data infrastructure that operates independent of practice setting,
- aligned multipayer incentives that support needed infrastructure investments,
- longitudinal patient-reported outcome measures (PROMs) captured both in-clinic and through mobile technologies,
- a series of robust regional demonstration projects to broaden stakeholder understanding and technical capability, and
- a governance mechanism that assures both simplification and alignment of methods.
Unfortunately, the current array of well-meaning, incremental, and voluntary efforts cannot achieve this essential transformation. National leadership and direction—from both government and industry leaders—are essential.
