Everywhere you turn in health care, someone is touting the importance of improving the "value" of care, but a survey released last week by the University of Utah finds the term has no universal definition—with patients, providers, and employers each defining it differently, Casey Ross writes for STAT News.
For the survey, which was conducted by Leavitt Partners, researchers collected and analyzed responses from more than 5,000 patients, nearly 700 physicians, and more than 500 employers.
While providers nearly unanimously cited the quality of care as a key measure of value, employers and patients typically said that "value" represented a combination of cost factors, patient experience, and worker productivity.
For instance, 88% of doctors cited quality of care as a critical factor in "value," making this the most-selected factor by physician respondents. In comparison, employers were most likely to cite cost, selected by nearly 60% of employer respondents, while for patients, the most-selected factor was affordable out-of-pocket costs, cited by 45% of patient respondents. Patients also were likely to cite definitions of value that included convenience, customer service, and quality.
Although physicians weren't as likely to cite cost as a primary factor in value, 76% of providers said that they consider cost when making treatment decisions, and 73% of providers expressed dissatisfaction with patients' out-of-pocket costs.
How to reach a universal definition of 'value'
Bob Pendleton, the chief medical quality officer at the University of Utah who worked on the survey, said the term "value" has become political "propaganda" in the health care industry.
"It seems to be used in any way people want it to be used, to fill their own agendas," he said. "The conversation around value is driven by large lobby groups—hospital associations and large corporate medical groups. What's missing is the voice of practicing doctors, patients, and employers."
Pendleton said most physicians don't have access to sufficiently accurate pricing information to have productive conversations about the cost of care with patients. "Somehow we have to create a path where in the clinic those costs can become an effective part of the conversation," he said. "Right now, they are certainly very opaque" (Ross, STAT News, 11/29).
The CFO's guide to value-based purchasing
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