National value-based purchasing program needed to drive improvement

The Department of Health & Human Services (HHS) should create a standardized national strategy for value-based purchasing (VBP) similar to the existing National Quality Strategy, argues a new study conducted by the RAND Corporation for HHS.

HHS should focus on three critical areas to drive the federal government's effective use of VBP, according to the study:

  1. Develop a national strategy: HHS should form a workgroup of representatives from agencies like the Centers for Medicare & Medicaid Services and the Agency for Healthcare Research and Quality to formulate the strategy, the study recommends. This strategy should clearly define the government's goals for VBP and what it considers successful outcomes, as well as a timeline and areas for measurement. "The strategy will also need to consider the interplay between various CMS VBP initiatives in working to advance federal goals for VBP and how those initiatives could better align incentives to providers," the study states.

  2. Define and coordinate a research strategy: Much is still unclear about VBP's effectiveness and what goes into a successful VBP program, the study states, so HHS must develop a coordinated, well-defined research strategy to answer these questions. "Currently, federal efforts to develop, test, and evaluate VBP programs are occurring setting by setting," the authors write. "This presents an opportunity to coordinate the evaluation work being performed across the various VBP initiatives within CMS to draw lessons across programs and provider settings that will inform the design and implementation of the next phase of VBP programs."

  3. Create a development strategy for measures that support VBP programs: Efficient, streamlined performance measures are vital for the transition to VBP, the authors write. These measures should incorporate not just processes of care, but also patient outcomes and proper use of services. "We encourage ASPE [Assistant Secretary for Planning and Evaluation] to work with measure development experts to chart a new strategy and process for developing measures to support VBP programs," they state.

Although value-based purchasing is a healthcare industry trend, the model may be particularly burdensome on public, safety-net hospitals, FierceHealthcare previously reported.

To learn more:
- read the study (.pdf)