Access, Care, Costs, Quality outcome-focused performance measures promote accountability; From a Public Health Perspective

I was tasked to reconcile the heavy load of health mobilization and promotion that I engage in with an inventory that can be used to measure performance. I want to see the clients I help go to hospitals smile again or I want to hear them talk about a plan to continue seeking professional health care.

The U.S. health care system today seeks to address broad themes such as: access, quality and affordability. Approximately 46 million Americans are uninsured, many who are insured face rapid increases in premiums and out-of-pocket costs. Congress and the Obama administration are seeking ways to invest new funds to reduce the number of Americans without insurance coverage. 

However, with price discrimination there is need to simultaneously address shortfalls in the quality and efficiency of care that lead to higher costs and to poor health outcomes. To do otherwise casts doubt on the feasibility and sustainability of coverage expansions and also ensures that our current health care system will continue to have large gaps — even for those with access to insurance coverage. 

Preventive care is underutilized, resulting in higher spending on complex, advanced diseases. Patients with chronic diseases such as hypertension, heart disease, and diabetes all too often do not receive proven and effective treatments such as drug therapies or self-management services to help them more effectively manage their conditions. There are variations in hospital inpatient lengths of stay, visits to specialists, procedures and testing, and costs — not only by different geographic areas of the United States, but also from hospital to hospital in the same town. Many patients often do not receive medically necessary care, others receive care that may be unnecessary, or even harmful. 

Encouraging efforts at the state and regional levels to enable public and private payers, including Medicaid and Medicare, to participate in private-public initiatives is aimed at using better, outcome-focused performance measures to support payment and benefit reforms that promote accountability for greater value.

patient care. Source: Wikimedia

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Drug Registration and Listing System (DRLS & eDRLS). Retrieved from: http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/DrugRegistrationandListing/ucm2007058.htm. Retrieved on July 9th 2016. 

Jonathan Blum. 2011. Improving Quality, Lowering Costs: The Role of Health Care Delivery System; Committee on Homeland Health, Education, Labor and Pensions United States Senate. Retrieved from: http://www.hhs.gov/asl/testify/2011/11/t20111110a.html. Retrieved on July 9th 2016. 

Measuring Health Care Quality:An Overview of Quality Measures. 2014. Retrieved from: http://familiesusa.org/sites/default/files/product_documents/HSI%20Quality%20Measurement_Brief_final_web.pdf. Retrieved on July 9th 2016.

Niall Brennan, Nicole Cafarella, S. Lawrence Kocot, Aaron McKethan, Marisa Morrison, Nadia Nguyen, Mark Shepard & Reginald D. Williams II. 2009. Improving Quality and Value in the U.S. Health Care System. Retrieved from: http://www.brookings.edu/research/reports/2009/08/21-bpc-qualityreport. Retrieved on: July 9th 2016.