Is Value-Based Purchasing the Future of Health Care?

As the health care system begins to shift towards a value-based purchasing system (VBP), hospitals are utilizing Pay for Performance (P4P) initiatives to monitor patient outcomes and patient satisfaction in accordance with Centers for Medicaid and Medicare (CMS) standards. The Journal of Healthcare Management says that this standard provides a financial reward or penalty based in part on measures of patient experience to promote patient health by creating an atmosphere that makes hospitalization more human with respect to patient values and preferences.

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a P4P initiative that many facilities currently have in place. Many nurses have heard of HCAHPS but don't actually know what it is or what it entails. In short, according to Health Services Research, HCAHPS is a survey designed to evaluate patient satisfaction of their short-term hospital care experience, which is tied to hospital reimbursement based on achievement or improvement from their baseline performance score.

So what makes patients happy in a hospital setting? A few categories that patients address on HCAHPS are communication, pain control, and medication explanation. This initiative has impacted facilities by transforming the culture of the work environment to one that promotes clinical quality care and service excellence. This might be particularly challenging for more experienced nurses who weren't taught service excellence as a part of nursing care. Leadership will need to examine strategies in creating a safe patient care environment by holding staff members accountable for providing consistency in customer service delivery. Because health care is such a major spender of government dollars, I believe that value-based purchasing isn't something that is going away any time soon.