Sunday, January 6, 2013

What Healthcare Value Is All About

By Maryellen Lamb


Healthcare value is determined by the outcomes attained by a patient for each dollar spent. The knowledge of this important factor is essential in improving the nature of medical care services provided. It facilitates reorganization of the care services, process improvement and promotes the use of proper cost reduction methods that favor the new approaches to both reimbursement and outcomes. This program has brought together all the stakeholders as they struggle to find new approaches to measure cost and outcomes

The principal goal of the care system is to improve the value for consumers. To achieve better health care the stakeholders in this sector should focus on three important elements. The delivery of this care should be designed around the patient, payment should be based on outcomes and there should be transparency in the quality of treatment and cost. These consumers have the right to know the cost and quality of the services provided.

Transparency is becoming a major factor in the care system. This has allowed customers access to adequate information which has enabled them to make comparisons of the prices and quality of services offered by the different providers. The patients are now able to make informed choices. The provision of reliable information has further empowered customer consumer choice and revolutionized the entire system.

Consumers have adopted new strategies to counter the ever rising costs and provide them with an opportunity to benefit from their investment. They have developed a culture of health where they are able to participate actively. They monitor the behaviour and consumption of care services through the realignment of incentives. The delivery of these services is return oriented and the consumers are now working with service providers to minimize costs and better outcomes.

The idea of quality has generated a lot of confusion. In practice, quality is defined as the adherence to specified rules and regulations and the measurement is based on care process. Process measures are not effective in showing true outcomes thus providers do not get the information necessary for innovation.

The failure to prioritize improvement of returns in the delivery of care services and to measure it has hindered innovation in this sector and led to poor methods of management which have led to increased costs. The measurement allows for reforms to the reimbursement system to provide bundled payments covering chronic conditions, full care cycle or periods of several years. It is important for providers to align reimbursement with value for them to be able to achieve good outcomes and also be able to account for substandard care.

Multiple organizations are involved in the provision of medical services. Among the many of these units, there is no single one that reflects the limits within which true value is achieved. The common denomination for measuring it should take into consideration all the activities that work jointly to meet all the needs of a patient. These needs are specified by the medical situation of the patient.

Healthcare value is measured in different ways depending on the type of medical care involved. The return for preventive and primary care is determined for patient groups with the same needs. A medical condition usually involves numerous specialties and therefore accountability for the return of this care is shared among all the providers involved.




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