Health care is rife with measurement. For both providers and payers, the time, effort, and resources dedicated to collecting and reporting data are exorbitant. While most reporting requirements are well intentioned, the proliferation is not adding value and—in some circumstances—does more harm than good.
Health care is already complex. All the measurement adds layers of complexity and bureaucracy. And the expense is considerable. A study published last year in Health Affairs showed that physicians and staff members in four types of practices (primary care, cardiology, orthopedics, and multispecialty) spend, on average, 15 hours a week per physician dealing with quality measures—which works out to about $40,000 annually per physician and $15.4 billion total.
This is not to say that compliance-driven measurement and reporting is unimportant. Reporting requirements on hospital-acquired infections have contributed to a reduced number of infections and the saving of an estimated 125,000 lives between 2010 and 2015. To support these efforts, standard quality measures with clear definitions and application that can be used industry-wide are being developed.
Lots of measurement
Still, there are an inordinate number of metrics, measures, and models developed by payers, providers, government agencies, and others that look at similar issues (e.g. quality, cost, experience) but from a variety of perspectives. Some standardization would help but it will provide only a grainy view of an organization's performance, particularly to those not well versed in the arcana of data science (like 99.999% of patients).
The result is that, ironically, in this era of rapidly increasing transparency, it remains curiously difficult for customers—which in health care can include employers and brokers as well as patients—to find useful information to support informed decision-making. The capacity for collecting data on all aspects of health care, including cost and quality, has outstripped the ability for many to use it.
In this data-rich environment, why is it so challenging for payers and providers to make the information relevant to their customers? The answer lies in how they have historically viewed the role of measurement and reporting. Both payers and providers largely see it as a matter of compliance—compliance with government regulations, with contract terms, with aggregator requirements—the list goes on and on.
Using metrics and measures to tell stories
The good news here is that some forward-thinking players are starting to use metrics and measures to tell stories aimed at attracting, informing, and retaining their customers. A list of data points is not enough. Instead, they must be woven into a coherent story. Easier said than done, right? Here's where to begin:
- Define the stakeholders. Consumer segments, purchasers, aggregators, and others are all likely key targets for messaging.
- Be clear about the value proposition. Importantly, your value proposition likely differs by stakeholder group, so messaging and the data to support will as well.
- Define the measures. This is not a matter of simply selecting which metrics to showcase with which audiences; we have already established that current reporting is not particularly valuable to customers. Aligning metrics with your value proposition requires careful thinking and articulation of a story line. Your story may require some entirely new measures.
In the absence of such credible and accessible messaging, customers are looking to other sources to distill information.
Take customer experience. Virtually every payer or provider has developed its own approach to measuring customer experience. The federal government has gotten into the game with the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), CMS's measure of the patient experience associated with inpatient hospital episodes. The information has failed to resonate with customers, and they don't look to provider, payer, or government websites when shopping for services. Instead, they turn to websites that provide information that consumers can relate to, such as Yelp.
And do you want Yelp telling your story to your customers, or would you rather do that yourself?
This article previously appeared in Managed Care Magazine.
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