About the Project
Measuring efficiency presents special challenges since there is no standardized way to assess costs in the context of quality. The National Quality Forum (NQF) will produce a white paper exploring:
- The current approaches in the field used for measuring and understanding efficiency
- The technical challenges of linking cost and quality measures to create an efficiency signal
- Best practices for combining cost measures with clinical quality measures to improve efficiency of care
Presently, there is no clear consensus among stakeholders about how cost and quality measures should be linked to understand health system efficiency. The white paper produced through this work of this project will provide guidance and a pathway toward developing efficiency measures.
Healthcare expenditures in the United States are unmatched by any country in the world, constituting for approximately 17.9% of our nation’s overall Growth Domestic Product (GDP).* Unfortunately, this spending has not resulted in better healthcare for Americans. The U.S. underperforms in terms of mortality, patient satisfaction, access to care, and quality of healthcare in comparison to other industrialized nations.
As ongoing health reform efforts focus on expanding coverage, increasing access to care, and reducing costs, it is important to understand how resources are currently being used in the system in the context of quality, preferably related to health outcomes. Linking resource use (or cost) and quality measures will enable the system to better evaluate efficiency of care. Several provisions in the Affordable Care Act (ACA), slated to be implemented over the next few years, require using resource use data to further support efforts to move toward a value-based purchasing (VBP) payment model.
Process
This project will be guided by an Expert Panel of representatives from across the spectrum of healthcare stakeholders. The Expert Panel will deliberate on efficiency measurement approaches and trade-offs identified in the environmental scan. They will recommend key methods to combine cost and quality and identify technical issues related to individual cost measures.
Funding
This project is funded by the Robert Wood Johnson Foundation.
For information about the availability of auxiliary aids and services for NQF’s federally funded projects, please visit: http://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html.
Related NQF Work
Contact Information
For further information, contact Erin O'Rourke at 202-783-1300 or via email at costandquality@qualityforum.org.
* "National Health Expenditures 2011 Highlights." Centers for Medicare & Medicaid (CMS), 2011. Available at http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/highlights.pdf. Last accessed October 2013.