Health Quality: A Big Win for Everyone

April 13, 2017

Back in the pre-ACA past, hospitals sometimes would respond to HQI’s attempts to recruit them for an improvement project by asking, “What’s the business case for quality?” We received this question from physicians in the pre-MACRA past as well, sometimes in the form of, “Well, where’s the ROI on that?”

As a former hospital executive, I understood this line of thinking completely. The facility or practice was providing the best care it could with the resources it had. Our reply eventually became, “Evidence-based practices and more reliable processes lead to better care that costs less to deliver.” But it still was hard to give them concrete proof that quality improvement benefits the bottom line.

Now, almost 15 years into the health quality portion of my career, I am glad the Centers for Medicare & Medicaid Services changed the conversation by putting money on the table. Performance has become part of how Medicare pays hospitals and outpatient clinicians.

HQI’s improvement activities have made it easier for hospitals to benefit from Medicare’s value-based payment program. We also are preparing 1,500 clinicians in four states to enter Medicare Advanced Payment Models and readying hundreds of large practices in Maryland and Virginia to succeed in the Quality Payment Program.

Will the fate of the ACA and the direction set by the new budget framework slow the pace or change the direction of improvement? Our impression from speaking with Congressional health policy aides and listening to health committee staff is a clear “No.”

Delivering better care is not only the right thing to do, it has become essential to the economics of health care delivery and Medicare’s future viability. HQI’s work with hospitals to reduce readmissions and prevent infections, for example, has contributed to a national total of 2.1 million fewer medical errors and 87,000 fewer deaths. It also saved CMS $20 billion.

I doubt patients, families and taxpayers will ever get tired of this kind of winning.

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