Evaluating the Impact of Value-Based Purchasing
Figure 1. A Bird's-Eye View of Value-Based Purchasing Strategies (Text Description)
In the flow diagram, two strategies of changing behaviors are followed by incremental goals for each, with defined goals of positive impacts on final outcomes.
Strategy 1 is to change the behaviors and decisions of consumers (for example, disseminating public reports on quality and offering financial incentives to choose high-value health plans.
Strategy 2 is to change the behavior and decisions of health care organizations or practitioners (for example, requiring accreditation, monitoring HEDIS® scores, and establishing financial rewards or penalties tied to effectiveness of care for specific conditions or diseases).
Incremental goals: A positive impact on intermediate outcomes.
For Strategy 1, examples of intermediate goals include:
- A greater percentage of consumers are aware that the quality of health care can vary.
- A greater percentage of consumers choose high-value plans or providers.
For Strategy 2, examples of intermediate goals include:
- More of the providers available through the plan's network are board-certified.
- HEDIS® scores indicate more appropriate levels of service utilization.
- Plans can document measurable improvements in effectiveness of care for specific conditions or diseases.
Ultimate goal: A positive impact on final outcomes.
- Better health status.
- Greater employee satisfaction.
- Lower costs.
- Greater competitiveness.