Increasingly, industry leaders recognize the strategic importance of considering patients’ needs, values and preferences, particularly as growth continues in consumer-driven health plans and calls grow louder for greater transparency around healthcare quality and cost. As both private and public payers create new payment models and providers accept greater levels of risk, there are opportunities to reexamine what healthcare measures are used, and in what ways. In this environment, organizations that ignore the patient’s voice risk squandering efforts on burdensome measurement that misdirects care, improvement efforts, and dollars away from what patients need and want.
Principles for making healthcare measurement patient-centered
Despite this growing recognition, many provider organizations, payers, and other stakeholders are unsure about how to realign their measurement efforts with patients’ priorities. The American Institutes for Research (AIR) recently released a set of Principles for Making Health Care Measurement Patient-Centered that help fill this gap. Patient-centered measurement involves partnering with patients in a meaningful way to decide what to measure, how to measure it, and how to report and use the results of measurement.
The five principles clarify that patient-centered measurement must be:
- Patient-driven: Patients’ goals, preferences, and priorities drive what is measured and how performance is assessed.
- Holistic: Measurement recognizes that patients are whole people and considers their circumstances, life and health histories, and experiences within and outside of the healthcare system.
- Transparent: Patients have access to the same data as other stakeholders and understand how data is used to inform decision-making around care practices and policies.
- Comprehensible and timely: Patients and other stakeholders get timely, easy-to-understand data to inform decision-making and quality improvement.
- Co-created: Patients are equal partners in measure development and have decision-making authority about how data is collected, reported, and used.
AIR developed these principles with support from the Robert Wood Johnson Foundation, Gordon and Betty Moore Foundation, and California Health Care Foundation by first bringing together groups of health care consumers in three cities—Chicago, Dallas and Durham, NC—to hear directly about what matters most to them. Building on these sessions with consumers, AIR convened a group of about 60 stakeholders, including patients, patient advocates, payers, providers, researchers, measure developers and policymakers, to identify core elements of measurement that is patient-centered.
Putting the principles into action
The five principles for making healthcare measurement patient-centered offer a starting place for organizations that recognize the strategic importance of aligning measurement efforts with patients’ needs, values and preferences. In presenting the principles, AIR offers examples of how to begin translating them into action. For example:
- To ensure that measurement is patient-driven, insurers ask their members with common conditions what good care outcomes look like for them. They use this input to identify measures that align with these patient priorities and base network, coverage and payment decisions on these patient-preferred outcomes.
- To ensure that measures used to monitor quality of common care episodes—such as maternity care—are holistic, health system leaders assess maternity care experiences, outcomes, and costs as a bundled whole, from pre-conception to post-delivery.
- To enact transparent measurement, insurers provide members with accurate information about out-of-pocket costs in advance of specific procedures.
- To make measurement comprehensible and timely, health systems use mobile or web-based technology to collect point-of-service data from patients, and use that data in real-time to inform quality improvement.
- To ensure that measurement is co-created, insurers partner with patients to determine which domains of quality are important for use in value-based purchasing or testing alternative payment models.
Partnerships for patient-centered measurement
Patient-centered measurement is not about putting the needs of patients above those of other stakeholders. Rather, it is about making sure that the patient voice is part of discussions—and decision-making—around measurement. To reap the benefits of patient-centered measurement, stakeholders must consider patients’ needs, values and preferences in equal measure to the needs and concerns of other key stakeholders. This will allow for increased information flow between stakeholders; improved partnership; and shared responsibility and accountability for outcomes. It will also create a foundation for collective action by a wide range of stakeholders.
These principles offer a vision of patient-centered measurement that is: patient-driven, holistic, transparent, comprehensible and timely, and co-created with patients. Putting these five principles of patient-centeredness into practice will improve organizations’ ability to drive meaningful change toward better health, better care, and lower costs.