How Can We Measure High Value Care? Consider the Patient Point of View

Jun 29, 2015, 4:43 PM, Posted by

Health care is centered around human relationships, which is why it's so important the voices of the people the system is designed to help—patients and their families—are heard by those defining and measuring care.  

Summer has come at last! Along with all the usual endings and beginnings that come with this time of year, there’s an important new opportunity for those of us who are passionate about improving health care. The Medicare Access and CHIP Reauthorization Act of 2015 threw out Medicare’s old rules for paying physicians and substituted a new system, one that’s  supposed to reward physicians for delivering high quality, high value care. This is a game-changer many years in the making, but as with any complex new law, the details matter. How will Medicare define and measure high quality, high value care? We can get some hints from CMS’ new strategic vision for physician quality reporting.

If I were granted just one wish by the people who are going to define and measure high value care, I know what I’d say: listen to our voices, the voices of patients and families, the ultimate health care consumers. Listening to patient voices and providing care that is patient-centered can improve clinical outcomes, reduce “waste” in health care by reducing unnecessary testing, and increase the overall care experience for both patients and providers. Health care is centered around human interactions and relationships—it is critically important that those defining and measuring care truly hear the voices of the people the system is designed to help—patients and their families.

I’m not alone in this wish, but it’s easy to get lost in the technical details of how to get patient point of view through the survey methodologies, the sampling frames, and data sources. The next time measurement experts need some inspiration, here’s where they should turn: to the people who live in communities who were part of the Foundation’s Aligning Forces for Quality program, RWJF’s ten-year effort to lift the quality and equality of care in 16 targeted communities. Aligning Forces for Quality communities were the earliest pioneers in measuring and making public information on the quality and costs of health care, and in beginning to tie those outcomes to how much providers are paid.

If you’re in need of inspiration, visit our website and sample one of the talks that spotlights how the voices of patients are transforming the health care system, and how much remains to be done.

Listen to Nate Hunkins in the video above. Nate brought me to tears with his bravery. He let his care team know when they let him down by failing to support him after a serious accident. "Patients like me who go through a dramatic and life altering event deserve more mental and emotional support from their doctors,” he said.  Nate’s story ends on a high note, however, stating,  “Having the courage to give feedback combined with a provider’s willingness to listen and act can result in a higher quality of care.”

Or listen to Moe Rustom, who saw first hand the devastation that occurs when the health care system can’t talk to patients in their own language. One pill a day for seven days? Or seven pills on one day? The results meant life or death.

Or Al Whitaker, who joined others in his community to help prevent and manage diabetes, and whose personal journey took him from fear and ignorance about his illness to celebrating healthy living.

Or Paula Jacobs, whose expertise in health disparities gets her thinking about the years of healthy, happy living her husband has enjoyed since undergoing cancer treatment ten years ago.  Paula knows that the story could have turned out differently had her husband been Black; the odds would not have been in his favor.

These stories, and others, remind us how important it to listen to the voices of patients, no matter how daunting the technical details may be. Now, let’s get to work.

Anne Weiss

Anne F. Weiss, a director for the Robert Wood Johnson Foundation, leads efforts to achieve the highest possible value from our nation’s investments in improving health and health care. Read her full bio.