The following is a continuation of the case study begun in Step 2. Next, Part 3 of the case study will demonstrate how to fill any gaps in data you may have in order to measure health, patient experience, and cost with the ultimate goal of studying value for your hypertension quality improvement program.
To prepare for value-based payment, you first focused on a small measurement and analysis project, your hypertension quality improvement program (step 2), and you chose measures that will demonstrate value (step 3). Since you will be using health data that are already reported out for UDS (percent of patients with hypertension with blood pressure levels under control), your next steps are to fill in gaps in patient experience and cost by collecting new patient experience data and approach your health center’s health plans to begin getting total cost of care data.
For patient experience, you have decided to collect new data by implementing a new survey targeting only the hypertension quality improvement program patients. Now, you work with your clinical staff to decide on measures that will not be overly burdensome to collect across the nine clinic sites in your health center organization. To capture patient experience, the team decides to ask patients one survey question at the end of their visit: “How satisfied are you with the care you received today?” Patients can respond that they are not at all satisfied, somewhat satisfied, or very satisfied. You give patients a slip of paper at the end of their visit with this question and the scale to answer anonymously. Patients drop the slip of paper in a box at the end of their visit. Patients seem happy to do this and since your clinical staff tallies the scores every other week, they do not feel overwhelmed.
For cost, you have decided to use the ambulatory sensitive hospital admission rate among program participants to fill the data gap in the short term. In the long term, in order to measure cost for this and other value-based quality improvement initiatives, you identify contacts at health plans your health center works with to obtain total cost of care data for your health center’s patients. After setting up business associate agreements to protect data confidentiality, you will give the health plans the names, dates of birth, and social security numbers of patients who seek care at the nine clinic sites within your health center organization. The health plans will identify the patients’ claims, and will provide you with patients’ total expenditures for a time period you both agree on.
In the next step, you will work on data visuals to assess value.