Measuring Hospital Quality

Quality of care is difficult to measure. Even if you had a perfect measure of quality in terms of health outcomes, risk adjustment is imperfect. For instance, academic medical centers are often assumed to have high quality, but actual outcomes observed in the data may not be that good if they also receive the sickest,…

Accountable Pharmacy Organizations?

Pharmacists are typically paid for dispensing drugs. They receive a fee to cover the price for acquiring a given drug and a dispensing fee. In general, however, pharmacists are not paid based on patient outcomes. Will that change? Troy Trygstad (2020) argues that value-based reimbursement for pharmacists through accountable pharmacy organizations (APOs) may be the…

Clinician-Directed Performance Improvement is the best way to improve quality…why won’t payers use it?

Goitein (2020) argues that Clinician-Directed Performance Improvement is the best way to improve quality. I agree. This approach empowers physicians and other health care professionals to identify areas for improvement and work on those. Clinician Directed Performance Improvement (CDPI)…had its origins in 2013, when a group of physicians requested support for a physician-led quality program…

Does the VA provide high-quality care?

This question is difficult to answer. In many countries with government provided health care, wait times are long. For the Veterans Affairs (VA) beneficiaries, this does not seem to be much of an issue according to a Penn et al. (2019) study covering wait times between 2014 and 2019: Although wait times in the VA…