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Better Healthcare Policy Group convenes in Washington, DC

March 14, 2024

The Better Healthcare Policy Group convened a meeting at the American College of Surgeons in Washington, DC, to catalyze discussions on the implementation of the Better Care Plan. The gathering included a diverse group of nearly 40 payers, employer coalitions, providers, patient advocates, patient safety and health quality professionals convening to discuss strategies to implement the Better Care Plan. Breakout sessions discussed key aspects of the Better Care Plan: value-based reimbursement strategies, certification and patient safety protocols and outcomes measurement and reporting.

BHCPG members at March 14 meeting (below from left to right): Jon M. Kingsdale, PhD., Dr. John Toussaint, Prof. Stephen M. Shortell, Allyson Y Schwartz, Gail Wilensky, PhD., George C. Halvorson, Peter A. Wadsworth, Prof. Richard M. Scheffler. For more information visit www.bhcpg.org.

Publicly Reported Health Outcomes: A National Initiative To Improve Care

Peter A. Wadsworth,  Stephen M. Shortell,  John S. Toussaint
(Health Affairs Forefront 7/19/22)

In this article, we describe the rationale and design criteria for a public-private approach to improving the quality and value of health care in the United States: a Publicly Reported Health Outcomes (PRHO) program. This long-term, aspirational initiative, focused on results and transparency, will require both public- and private-sector action.

Rationale

The US currently lags behind most Organization for Economic Cooperation and Development (OECD) countries in life expectancy, infant and maternal mortality, and many other measures of mortality and morbidity. While many factors contribute to this quality gap, huge variations in health plan and hospital mortality rates suggest that US health outcomes could be substantially improved. In fact, recent research demonstrates that hospital mortality rates can vary by a factor of 3 to 1 and health plans by 4 to 1, and publicly available quality ratings of health care plans and services do not correlate well with outcomes. What is more, lack of transparency among health plans and provider organizations prevents purchasers from making informed choices based on relative quality of provider organizations and health plan networks. Currently available outcomes data are limited to Medicare fee-for-service.

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The Better Care Plan Advantage

Peter A. Wadsworth (LinkedIn 12/11/2020)

Better Care Plan logo

The Better Care Plan is a national health strategy to improve the affordability of health coverage and the quality of care received by Americans. It was developed by these eight senior healthcare executives, economists, and health policy researchers.

Conclusions

Medicare Advantage plans currently outperform Medicare fee-for-service (Parts A, B and D), and there is reason to believe that the performance gap will widen in the future as we enter “a golden age of healthcare” due to several trends:

  • Growing integration of providers into coordinated care teams or integrated delivery systems.
  • Growing use of pre-paid, risk adjusted and other value-based provider reimbursement.
  • Growing use of IT solutions to integrate and coordinate care, measure results in real time and provide patient-specific services that have traditionally been available only on a limited basis.

There is ample evidence that offering plans similar to Medicare Advantage to Americans under age 65 will accelerate the adoption of these trends while reducing the per capita cost of care and improving health outcomes. While the Biden-Harris plan, if fully implemented, will likely address the problem of universal coverage, both public and private sectors will continue to experience growing healthcare expenditures. Only when the healthcare providers are paid to keep people well rather than providing more healthcare services will this paradigm change. The Better Care Plan is perhaps our best opportunity to begin to effect that paradigm shift.

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