Making the Jump to Value

Janice Simmons, for HealthLeaders Media , September 24, 2009

Among those institutions, regions, and those states that have high-value organizations, Cortese said they have a few common characteristics:

  • A higher level of a cultural focus is aimed at the needs of the patient. "There's more patient-centeredness thinking going on in those organizations or by those groups of providers that band together in communities or in states that have created better environments for caring for people," he said. "They are focused more on the patient."
  • A higher level of physician or provider engagement, leadership, and change is found among those taking care of patients. Specifically, a higher level of teamwork and collaboration is implemented when making medical decisions for patients.
  • A higher level of coordinated care is found where the teams use integration and coordination in managing the patients themselves. This can involve areas from how appointments are scheduled to are follow-ups.
  • A higher rate of sharing of medical records and information is found from one place to another. "With these galaxies of good delivery of high-value care, there's a fair bit more of connectivity about information than there is elsewhere," Cortese said.
  • Focus is placed on "the science of healthcare delivery." This means systemically looking at the ways patients flow through an organization—for instance, reviewing how certain processes can be done to reduce errors.

So, how does the country and all healthcare organizations get there? Cortese made a suggestion that it can start with Medicare as the country's largest payer—by paying for value. "The vision is to get there is a reasonable amount of time," he said.

And the country may be starting to point in that direction. Earlier this week, Senate Finance Chairman Max Baucus (D-MT) included an amendment in a modified version of his healthcare reform bill in which Medicare would place value of services over volume of service when paying for physician services. As proposed, Medicare under this amendment would begin paying for value beginning in 2015.

Cortese agreed that making a change to considering value can't happen all at once. "You can't jump a 40-foot chasm in two 20-foot steps," he said. Instead, it will take small steps—one after another—to make the big jump to value.

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Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at

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