While healthcare providers are getting ready to implement more value-based payment programs, such as the new Medicare reimbursement system for physicians, regulators are trying to improve and speed up feedback from providers and patients.
Dr. Kate Goodrich, director of the CMS Center for Clinical Standards and Quality, said during a panel discussion at the annual Health Datapalooza conference in Washington D.C. Tuesday that Medicare's new Quality Payment Program was developed by deploying CMS employees into the field, and having them observe providers as they collected and reported data used to determine quality measures.
The CMS also looked at how quality measures affect rural and safety net providers, as well as teaching hospitals, she said.
In a separate address at the conference Tuesday, acting CMS Acting Administrator Andy Slavitt said the way technology is used in healthcare now is too often frustrating for physicians, and presents patients with a fragmented system when they need help and guidance the most.
There is an urgent need for healthcare technology and data gathering to be designed around patient and provider needs, not regulations, Slavitt said.
Those in healthcare who want to keep their data in a silo or not use standards that allow for collaboration should “pick a new business model or pick a new business,” Slavitt said.
Patient involvement should be an important facet of value-based payment models and has so far been lacking, Goodrich said, adding that patients' input needs to be more than just the viewpoints of patient advocacy groups.
“There is a voice that is not really being brought to the table and that is the average American with an illness,” said Dr. Paul Bleicher, CEO of Optum Labs.
Dr. Helen Burstin, chief scientific officer with the National Quality Forum, said data used for determining quality need to better capture care coordination and communication to patients. What may look like high-quality care based on a few data points could still leave a patient confused and unsatisfied, she said.
“The limitation there is that it's really hard to do with the data we have available now,” Burstin said.
There are some barriers to making the most of health data, she said. The data must be useful, shareable and obtained from a large enough sample size. Limited time and financing makes that data gathering and analysis difficult for many providers.
Patient information like genetics, demographics, socio-economic factors, environment and health behaviors are important to understand how well treatments work. But it is also important to understand the patients' perceptions of the value of care and their descriptions of symptoms, Burstin said.