Mandate Outcomes Reporting

Robert S. Kaplan; Michael E. Porter

Article | Health Management, Policy and Innovation | 2019

Mandate Outcomes Reporting

by Robert S. Kaplan and Michael E. Porter

Abstract

Currently, few health care providers measure and report their patient outcomes, which leads to several problems. Attempts to introduce price transparency without outcomes transparency could trigger a “race to the bottom.” Should Medicare coverage be expanded to non-elderly populations, its much lower reimbursements will create pressure on providers to lower their spending in ways that produce even worse outcomes. Even without Medicare expansion, the lack of systematic outcomes measurement has made the migration from fee-for-service to value-based reimbursements, especially bundled payments, less effective and more difficult to implement. Hidden variation in outcomes prevents providers from learning from others how to produce better outcomes for their patients. We propose that the Congress elected in November 2020 mandate the Centers for Medicare and Medicaid Services to begin requiring outcomes measurement by all providers reimbursed under government Medicare and Medicaid programs.

Keywords: outcomes reporting; outcomes measurement; Medicare; Medicaid; Health Care and Treatment; Outcome or Result; Measurement and Metrics;

Format: Electronic

Read Now

Citation:

Kaplan, Robert S., and Michael E. Porter. "Mandate Outcomes Reporting." Health Management, Policy and Innovation 4, no. 3 (2019).

Leaders at six hospitals conducted a research study to assess and compare the health outcomes and costs of pediatric aerodigestive care. Four of the hospitals delivered care with an integrated practice unit (IPU) while two delivered care traditionally, with isolated specialists. The study used time-driven activity-based costing as a tool to measure and compare costs across the six sites. The results demonstrate that the four IPU sites improved clinical outcomes and had lower costs of care.

Value-based care models are becoming instrumental in structuring clinical care delivery in our healthcare climate. Our objective was to determine the value associated with implementation of a Family-Centered Care Coordination (FCCC) program for neonates undergoing tracheostomy.

Article | American Heart Journal

Are Cost Advantages from a Modern Indian Hospital Transferable to the United States?

R. S. Kaplan, F. Erhun, V.G. Narayanan, B. Mistry and K. Brayton, et al

We use time-driven activity-based costing to estimate the cost of personnel and space for an elective coronary artery bypass graft (CABG) surgery at two U.S. hospitals, Intermountain and Baylor Heart, and Narayana Health (NH), in India. All three hospitals use modern management methods to achieve excellent patient outcomes. We use variance analysis to remove the effect of differential prices paid for personnel and space at the three hospitals. NH, even at U.S. price levels, retains a cost advantage over the two U.S. hospitals by shifting tasks to less-credentialed and/or less-experienced personnel, supervised by highly-skilled personnel, a practice facilitated by NH’s high annual CABG volume. NH offsets some of its task downshifting cost savings by having lower-skilled employees spend more time counseling patients and their families for in-hospital and home recovery. NH’s cost-saving practices could be captured by U.S. hospitals by relaxing hospital and health professional licensing regulations, encouraging greater family participation in inpatient care, and performing complex surgeries in high-volume regional centers of excellence.

Keywords: Time-Driven Activity-Based Costing; Health Care and Treatment; Cost; Organizational Structure; Performance Efficiency; India; United States;

Citation:

Kaplan, R. S., F. Erhun, V.G. Narayanan, B. Mistry, and K. Brayton, et al. "Are Cost Advantages from a Modern Indian Hospital Transferable to the United States?" American Heart Journal 224 (June 2020): 148–155. View Details

Cite View Details Read Now

Faculty & Research

Mandate Outcomes Reporting

Abstract

Citation:

About the Authors

More from these Authors