In the February 2012 Impact Analysis Report, Value-Based Purchasing: Facing the HCAHPS Hurdle, HealthLeaders Media Council members were evenly divided on whether VBP, as designed, will succeed in improving quality of care while also reducing costs. We asked four leaders: What is the outlook for your organization, and what are the reasons it will succeed or fail?
Scott Trott, MHA
Vice president of payer management and faculty services
UNC Healthcare System
Chapel Hill, N.C.
On the outlook for VBP:
Our outlook is good from the perspective that the patient experience component is already very high. The clinical components need improvement and we have active programs in place around all of those measures. It will succeed in the near-term based on the organizational approach of looking at this across the board for our health system.
We have a couple of our major commercial contracts that have many of these measures in them as well, so we have some synergy between the governmental and commercial payers. One thing that might lead to its failing is if we get focused on multiple other measures or other payer-specific measures that aren't in sync with value-based purchasing core metrics.
On incentivizing physicians:
The other part of this is keeping our physicians engaged. Another year or so of having incentives built in to help keep physicians engaged in helping to drive these changes and improve these measures and is absolutely critical. Some incentives have to be built in, maybe it's an internal thing that we need to do, where our physicians have the chance to benefit as these scores improve.
On reducing cost of care:
I am not sure if cost will actually be reduced. So many of these clinical measures are based and predicated on folks who are in the hospital or have had an encounter, and costs are really mostly reduced when you avoid having folks come in from the beginning. This kind of value-based purchasing is focused on inpatient or acute events.