Why Is Value in Healthcare Important to Consumers Today?

Consumers want convenience, quality and reasonable prices when they spend money — whether eating in a restaurant, buying a TV or taking a vacation. More and more, these same value principles come into play when making decisions about healthcare. “As patients assume increased financial responsibility for their healthcare through higher deductibles and copays, they are looking for more bang for their buck — more value in healthcare,” says Eric Fontana, Practice Manager, Research and Insights, The Advisory Board Company. “This unquestionably is a trend that will continue.”

Source: Medicare’s Summary Star HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) Ratings; Medicare.gov Hospital Compare web site for period 7/1/2013 - 6/30/2014.

There is more public data available today than ever to help patients evaluate where to go for the highest quality and a reasonable cost. One source is Medicare’s new Summary Star Ratings (see top chart), which allow consumers to compare hospitals using a five-star scale, with more stars indicating better quality care. The Star Ratings are based on a survey of patient ratings and perspectives on their care while hospitalized, including communication by doctors and nurses, pain management, cleanliness and quietness of the facility, and preparation for discharge, among others. Virginia Hospital Center received four stars, the highest rating of any hospital in the Washington, DC metro area.

Source: Medicare.gov Hospital Compare web site based on 2015 Value-Based Purchasing results *Mayo Clinic’s Campus in Arizona.

Another source is the Hospital Value- Based Purchasing (VBP) program of the Center for Medicare and Medicaid Services (CMS), which links Medicare’s payment system to a value-based system to improve healthcare quality (see bottom chart). Under VBP, hospitals that accept Medicare are rated on critical measures, including quality, patient experience, safety, mortality, infection rates, readmission rates and cost. Depending on their performance on these key measures, hospitals can either earn a bonus or receive a penalty that reduces their payments.
Out of more than 3000 hospitals in the U.S., Virginia Hospital Center ranked among the top 12%, or in the 88th percentile for the VBP program — the highest ranking performance for any hospital in the Washington, DC metro area. “A hospital’s VBP score is very telling,” says Jeffrey DiLisi, MD, Vice President & Chief Medical Officer, Virginia Hospital Center, “because it encompasses so many important measures of quality including mortality and infection rates.” It considers whether the hospital complies with evidence-based standards.
Is the right antibiotic given before surgery? Does the hospital follow best practices for controlling infection? In the area of patient experience, it covers such critical issues as how well doctors and nurses communicate with their patients and whether patients understand what they need to do after leaving the hospital. It takes into account how often patients are readmitted to the hospital within 30 days after being discharged. “Hospitals that rank in the top 10 to 15% in the nation for Value-Based Purchasing are performing pretty well all across the board,” says Fontana.
“The VBP program is designed to promote better clinical outcomes and improve patient experience during hospital stays. The hospitals that did well on these measures put the patient first. It’s all about the patient,” says Dr. DiLisi.

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