Value-based purchasing can help align reimbursements with desired health care outcomes. Demonstration projects, such as the Premier Performance Pays study, are proving that when evidence-based processes are delivered, quality is higher and costs are lower.
P4P initiatives should be very carefully considered. Successful adoption of P4P requires that all stakeholders participate in the design and selection of quality measures. P4P programs should be incentive-based, not punitive, and should encourage a culture of continuous quality improvement. Financial incentives should reward those who demonstrate improvement or exceed benchmarks, as well as sustain quality.
A holistic quality assessment system must be developed and adopted for use in health care. Systemic review of processes, practices, and policies is essential to improve quality in the health system.
Safe practice standards should be evidence-based, flexible, and feasible. Nationally recognized safe-practice standards should be developed only through analysis of conclusive data on broad-based effectiveness and feasibility, and should consider evolving science.
Efforts to improve quality should consider the larger context. A hyperregulated, litigious, and price-controlled environment reduces the time, resources, and ability of health care organizations to implement the necessary technology that can improve quality.
Congress should very carefully consider any efforts to reduce the budget deficit. Provider resources are essential to continued progress on improving patient safety. If Congress were to pass legislation reducing provider payments, it would dramatically affect the ability of doctors and hospitals to continue making quality improvements.
