Business
Case
Provider
Efficiency White Paper - The Business Case for Pay-for-Performance
The work contained
in this
White Paper reflects the efforts from health plans, employers,
consultants, and providers to define a set of recommendations
- Best Practices - that have the potential to improve the
measurement of provider efficiency and the science behind
it. While the paper focuses on efficiency, all the contributors
acknowledge that measuring efficiency should be done in conjunction
with measuring effectiveness of care, so that consumers, purchasers
and payers can better understand and identify the value of
the services being delivered, and providers can better understand
the steps they need to take to improve the value of services
offered.
None of the parties
would suggest that these are the final (or the only) word
in provider efficiency measurement, quite the contrary, which
is why we have referred to this paper as Version 1.0. Nor
do we suggest that all recommendations should be adhered to
strictly. In fact, we recognize that many readers of this
paper will struggle with how to implement some of the recommendations,
or with how it will impact their organization. In doing so,
they should recognize that, as an industry, we are still in
the early stages of developing adequate universally accepted
rules on how to measure the efficiency with which doctors,
hospitals and other care providers deliver services. As such,
it will be extremely important as we go forward to closely
collaborate and create a community of continuous learning,
understanding better the power of analysis when some of the
recommendations are not applied as opposed to being applied.
Continuing the experimentation will allow all of us to arrive
at a better model, and we are committed to updating the recommendations
periodically to reflect new findings.
This continuous
learning should be approached in the same spirit as the development
of the Linux software code - anyone can take what we have,
but contribute back any improvements you can make. It is only
through this sort of collaboration, where best practices will
be shared openly, that we can advance the science, reduce
the barriers to implementation and jointly create a better
health care system. To that end, an on-line forum has been
set-up at www.regence.com/research
where the discussion we have started here can be continued.
As referenced in
the White paper, the documents below refer to Hospital efficiency
and the need for mission-adjustments, they detail findings
from a study about what adjustments to make and how to make
them.