Quality and Value

Words sometimes mean something. But at other times the mean a lot of different things and oftentimes they mean nothing at all. Take Quality and Value. I am always drawn back to the Quality idea that drove the prime character in Zen and the Art of Motorcycle Maintenance to insanity. He spent a lifetime trying to define it. Perhaps like pornography it is in the eyes of the beholder. But what is quality to me may not be quality to you.

The value in Health Care is all too often measured in QALYs, the subjective measure of the use of some treatment or lack thereof. In fact the ACA was written to prohibit its use. Alas, with the current administration even their own laws don't count!

Now in Healio we have an interesting piece worth tracking. They state:

In esponse to concerns over Medicare’s current fee-for-service payment system, the Obama administration announced in January that by 2018 Medicare instead will aim to associate half of all payments to the quality and value of health care provided...Some of the changes that private insurers and the government are hoping to advance are the use of bundle payments, population-based payments and Accountable Care Organizations....under the Affordable Care Act, Medicare will be cut significantly....“Relative to the rates that private insurers pay, the rates for Medicare and Medicaid are going to trend down over time. In fact, by the middle of the century, they are going to be about half of what private insurance pays hospitals,” he said. “We should be concerned that quality may suffer unless we do something about this.”...Research has shown that when Medicare payments to hospitals are cut, it leads to higher patient mortality and other negative outcomes,...

Yes, cut Medicare and people die. But ironically the Democrats blame the Republicans for that yet it is the ACA which mandates it.