Top Ten Action Items to Adopt Best Practices
1. Value-based healthcare. Create a cost and comparative effectiveness initiative that certifies public and private evidence-based practices. Government health programs should then reward organizations that adopt these best practices through higher reimbursements.
2. New payment models. Develop a policy roadmap to replace current physician reimbursement models, including the Resource-Based Relative Value Scale (RBRVS) and the Sustainable Growth Rate, with a model rewards the use of best practices, chronic care management tools, information technology and emphasizes patient wellness. The delivery reform proposal released in November 2008 by Kaiser, Intermountain Healthcare and the Mayo Clinic provide a range of options that would be vast improvements over the status quo, including bundled or episode-based payments, accountable care organizations and chronic care coordination payments.
3. Liability protection. Extend federal liability protection to providers who follow established clinical guidelines or use certified best practices.
4. Transparency. Release price and quality information from all government health programs—Medicare, Medicaid, Veterans Affairs, and FEHBP—for all providers, suppliers and health insurers that do business with the federal government so that taxpayers can see which organizations provide the best and most efficient care.
5. Physician practice. Improve and then expand nationwide the CMS Group Practice Demonstration.
6. Medical home. Expand provider eligibility for the CMS medical home demonstration.
7. Hospital quality. Expand nationwide the CMS Hospital Quality Incentive Program.
8. Provider reporting. Improve and expand the Physician Quality Reporting Incentive (PQRI) to enroll more eligible physicians.
9. Reward health and wellness. Give private health plans, including those that participate in Medicare and Medicaid, more latitude to design insurance products to encourage, incentivize and reward individual healthy behaviors.
10. Medical error reporting. Provide limited liability protection and incentives to publicly report and publish data on medical errors.
2. New payment models. Develop a policy roadmap to replace current physician reimbursement models, including the Resource-Based Relative Value Scale (RBRVS) and the Sustainable Growth Rate, with a model rewards the use of best practices, chronic care management tools, information technology and emphasizes patient wellness. The delivery reform proposal released in November 2008 by Kaiser, Intermountain Healthcare and the Mayo Clinic provide a range of options that would be vast improvements over the status quo, including bundled or episode-based payments, accountable care organizations and chronic care coordination payments.
3. Liability protection. Extend federal liability protection to providers who follow established clinical guidelines or use certified best practices.
4. Transparency. Release price and quality information from all government health programs—Medicare, Medicaid, Veterans Affairs, and FEHBP—for all providers, suppliers and health insurers that do business with the federal government so that taxpayers can see which organizations provide the best and most efficient care.
5. Physician practice. Improve and then expand nationwide the CMS Group Practice Demonstration.
6. Medical home. Expand provider eligibility for the CMS medical home demonstration.
7. Hospital quality. Expand nationwide the CMS Hospital Quality Incentive Program.
8. Provider reporting. Improve and expand the Physician Quality Reporting Incentive (PQRI) to enroll more eligible physicians.
9. Reward health and wellness. Give private health plans, including those that participate in Medicare and Medicaid, more latitude to design insurance products to encourage, incentivize and reward individual healthy behaviors.
10. Medical error reporting. Provide limited liability protection and incentives to publicly report and publish data on medical errors.
