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Patient Input Vital for Meaningful Value-Based Care Measures

Healthcare experts should consider patient input during value-based care measure development.

Patient input is valuable for value-based care measure development.

Source: Thinkstock

By Sara Heath

- As healthcare continues a value-based, patient-centered trajectory, industry experts must consider patient input in value-based care measures.

While healthcare stakeholders know that patient input is a key determinant of quality healthcare, the industry standards are nonetheless behind. Research shows that mandated clinical quality measures rarely portray an accurate picture of the patient experience, suggesting an overhaul of these measures to better ensure patient satisfaction.

Heritage Provider Network President Mark Wagar explained that the industry can trust the patient to thoughtfully and effectively inform some of these value-based care measures. Gone are the days of a paternalistic patient-provider relationship.

Opening up this relationship to a partnership will help drive quality in healthcare, Wagar said in an interview with PatientEngagementHIT.com.

“We still come from a long history of believing that healthcare is too complicated for patients to fully understand,” Wagar explained. “While that may be true of many of the sophisticated scientific things, patients aren’t stupid. They can tell if they are being well served, if someone is attempting to be responsive to their questions in a reasonable and educated manner.”

READ MORE: How Healthcare Pros Measure Patient Engagement, Satisfaction

Patients are intuitive and perceptive, Wagar asserted, and thus are instrumental in developing quality healthcare measures. While patients cannot always speak to the quality of a certain procedure (but effective treatment also should not be minimized), patients can identify an empathic and respectful doctor.

As patients face increasingly high out-of-pocket costs and financial responsibility, industry experts – including Wagar – claim that it only makes sense to allow patients to shape and identify what defines quality healthcare.

“It’s healthy for patients to understand that doctors, nurses, and social workers are held to a set of expectations that overall drives a higher likelihood of a better outcome and good service aspects and a higher likelihood of better costs over time,” he explained.

“We should be open and transparent about the fact that we will get paid more or less for both clinical effectiveness and patient experience,” Wagar continued.

The actual measures used to inform value-based reimbursements need to be shared with patients and simplified on consumers’ terms to accomplish this mission. According to Wagar, this doesn’t require getting rid of measures to becoming reductive about the nuances of quality healthcare.

READ MORE: Should Value-Based Care Measures Become Patient-Centric?

Instead, it means creating a set of basic benchmarks and then developing value-based care from there.

“We’ve made most of those measures too complex for ourselves in the delivery system – if we can’t explain it to ourselves, we can’t explain it to a patient,” Wagar pointed out. “We should work to make it a more easily understandable set of service expectations. It might have 20 components to it, but we should be able to boil it down to five points and run it by the patient.”

Adding patient input into value-based care measurement can only result in higher quality care and a better overall patient experience, Wagar contended.

“In healthcare’s instance, you’ll benefit from more information, particularly because socioeconomic determinants we now understand account for half or more of what we do in healthcare,” he explained, noting that understanding the whole patient will help develop a set of standards necessary for quality care.

“You need to do a lot more than listen to a person’s heart,” Wagar continued. “You need to know what’s in their heart and in their brains other than what can be physically tested.”

READ MORE: How Hospitals Can Raise Patient Satisfaction, CAHPS Scores

Urgent care centers are a paramount example of integrating person-first strategies to prove – and improve – care quality.

“When urgent care centers were developing, they were viewed as second-class places for care,” Wagar recalled. “One of the things that they did most effectively was following up and calling patients to see how they were doing later.”

Collecting patient input eventually had its payoffs, Wagar said.

“Patients were stunned,” he noted. “Soon urgent care centers became popular, trusted places to go versus what had been a fairly sterile emergency room experience where you never heard from anyone until you were billed.”

This can be the case with virtually any healthcare facility. Hospitals and clinics that collect patient preference data will eventually become better performers, at least by patient standards. On a macro scale, a set of national reimbursement measures based on patient needs will ideally result in quality improvement nationwide.

Adding patients into the value-based care mix will require extensive leadership development. As health systems become more complex and integrate a web of academic hospitals, ambulatory clinics, and other smaller facilities, it will be important for them to create both top-down and local change based on leadership.

“Then you get into the human aspect so you need to develop a culture. Change is based on leadership,” Wagar pointed out.

“At Heritage, we engage our clinical people and our administrative employees in identifying the things we can do to improve. What are the most important things? What do we hear from patients? Let’s look at not only our survey results, but from the people who talk with the patients as well.”

This tactic – whether used in a single clinic, an expansive hospital system, or across the country – will ideally lead to higher quality healthcare.

While clinical and diagnostic may still be in the doctor’s domain, it is key that industry leaders start integrating patients into the rest of the picture. In doing so, healthcare professionals can ensure treatment that meets patient standards and truly qualifies as quality healthcare.

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