Health care consumers, payers and providers are experimenting with reforms to how healthcare is delivered and paid for, but a lack of standardized measurement tools make it difficult to differentiate what works from what doesn't.
A standard approach to evaluating payment reforms would send a clear signal to those sponsoring reform efforts about what outcomes are most meaningful to purchasers, consumers, and other stakeholders.
Berkeley, Calif.-based Catalyst for Payment Reform, a nonprofit healthcare advocacy group, surveyed payment reform experts and health insurers about payment reform programs. Below are four key areas to address when evaluating these programs:
1. Program Design. It is important to understand how a program is designed, its goals, the lines of business in which it is offered, its availability by region and market and which purchasers and payers are eligible to participate.
2. Feasibility. To participate in payment reform programs, employers and other private healthcare purchasers must understand the financial benefits and investments involved.
3. Cost. Employers and health care purchasers must understand the mechanisms through which the program intends to reduce costs, its impact on total healthcare spending, and how any savings may be passed on to them.
4. Quality. Quality assessment tools must focus on priority areas — highest areas of employer care spending and areas of care quality and price variation for the same services.