HPCI News: Harvard Business Review on Quality Measurement

To: Members and Selected Others

The Harvard Business Review recently posted an editorial entitled “U.S. Health Care Reform Can’t Wait for Quality Measures to Be Perfect”. It was written by four leaders of national purchaser-driven organizations ---the National Business Group on Health, ERSA Industry Committee, National Alliance of Healthcare Purchaser Coalitions and the Leapfrog Group.

The editorial calls for going full-speed-ahead on using valid quality and safety measures for public reporting and payment. Key points:

  • Even imperfect measurement and transparency accelerate quality improvement. For example, the Leapfrog Group’s first-ever reporting of early elective delivery rates by hospitals in 2010 galvanized a cascade of efforts to curtail the problem and thus reduce maternal harms and neonatal intensive care unit admissions. This was effective. The nations mean of early elective deliveries declined from a rate of 17% to 2.8% in only five years.
  • Making measures public is key to accelerating change. As the Lucian Leape Institute concluded in 2015, “If transparency were a medication, it would be a blockbuster”.
  • Use of these measures is often necessary to break logjams in correcting the health care industry’s long-neglected weaknesses in data-quality control.
  • Returning to fee-for-service is not an option. Given the widely acknowledged waste, heavy costs, and quality-of-care issues produced by the fee-for service system, the fact that there are rough spots on the road to value-based payment is hardly a justification for showing down reform. The change to performance-based payment and market share requires tenacity and patience. While current quality measures may have rough edges, stakeholders have worked hard to steadily improve their validity and reliability.

The Harvard Business Review post at editorial in its online edition.

Paul M. Pietzsch, MPH
HPCI - IHBA Office
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West Des Moines, Iowa 50265
(515) 778-6300

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