With patient-centeredness as the latest buzz word in health reform, many organizations know they are working toward the patient-centered goal but still question what it is exactly. Legal experts at the ECRI Institute's 18th Annual Conference at the FDA in Silver Spring, Md., on Tuesday said the definition can vary, depending on who you talk to.
For example, what is a patient? Some organizations look at the individual patient and his or her needs, while other organizations consider populations of patients and the needs of the community. Still, others define the "patient" part of the equation to include family members.
Similarly, the "centered" part of the definition can vary. To some, it means shared decision-making, while others see it as being the best interests of the patients.
The Institute of Medicine, as well as Medicare, focus on the "care" part of the definition; patient-centered care is delivered to the patient with consideration to his or her values, notes Jane Hyatt Thorpe, associate research professor at the George Washington University School of Public Health and Health Services in Washington, D.C.
Meanwhile, the Affordable Care Act stresses the patient part in providing care that incorporates respect and dignity, according to Thorpe.
With about 20 references to patient-centered care in the Affordable Care Act, patient-centeredness isn't only a trend, it is regulation. And as newly resigned Centers for Medicare & Medicaid Services Administrator Dr. Donald Berwick highlights, patient-centered care is about providing the right care for the right person every time.
Like the law, patient-centered care is multi-faceted, Thorpe notes. It will play an increasing role in regulation with informed consent, advanced directives, fraud and abuse, liability and standards of care, and of course, in delivery models.
Michael Park, counsel for Alston and Bird, explained that patient-centered care is changing the way we look at care delivery, particularly in the hospital setting.
Value-based purchasing (VBP) programs weight the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey performance as 30 percent of the total VBP performance score, with the other 70 percent based on process of care measures.
"Patients will play more of a role in how hospitals will be reimbursed," Park said.
For more information:
- read the CMS website on VBP programs
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