Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:Quality Measurement and Improvement
Lecture:Definitions and framework for assessing quality
What is known about health care quality
Slide content:Other Definitions Pay for performance (P4P) (Rowe, 2006) Often equated with quality assessment but is just one approach (Rosenthal, 2008) Based on notion that health care providers and organizations should be held accountable financially and otherwise Value-based purchasing (CMS, 2016) Application of P4P Accountable health care ( Chassin et al., 2010) Health care that is accountable to patients, purchasers, and others Transitions of care Population health 9
Slide notes:Another term discussed often in the context of quality is pay-for-performance , sometimes abbreviated as P4P [P-for-P]. In fact, some people equate quality assessment with pay-for-performance, but its important to remember that pay-for-performance is just one approach to measuring and acting on health care quality. The notion behind pay-for-performance is that health care providers and organizations should be held accountable financially for the quality of care. But of course providers and organizations need to be held accountable in other ways as well; however, its one way to bring about improvements in the quality of health care. Another term is value-based purchasing , which is really just an application of pay-for-performance. Value-based purchasing means that consumer decisions to purchase health care are based on quality, and they may decide to not purchase health care from a hospital or a physician or physician group. Employers have adopted value-based purchasing relatively slowly even though employers use value-based purchasing in everything else. For example, car manufacturers look at the value of the steel that they purchase, and the food industry looks at the quality of the food, yet with the health care that employers provide to their employees, theres very little in the way of seeking value. Of course, part of the motivations for the health care quality movement is to change that. Another term gaining favor is accountable health care , which means that health care providers and organizations must be accountable to patients, purchasers of health care, and others. This also involves demonstrating positive patient outcomes across transitions of care. The term care transitions refers to [quote] the movement patients make between health care practitioners and various settings as their condition and care needs change during the course of a chronic or acute illness. [end quote] Transitions of care are a set of actions designed to ensure coordination and continuity of the patients care. Population health is also critical across populations of care. 9