Disruptors, innovators, big data apps and monitoring tools, quality teams and so much more is invested in improving health outcomes for patients. So many health care stakeholders are working hard to find the golden holy grail of impactful tools to improve quality scores and health outcomes. But a recent study by Stanford Medicine’s Clinical Excellence Research Center examining quality and cost found virtually zero correlation between high cost providers (inevitably offering those disruptive, cutting edge tools) and improved health outcomes as measured by 85 quality metrics.
The study presented at the Pay for Performance Summit in San Francisco earlier this week, contrasted one composite score derived from 85 HEDIS, Medicare Star, and NQF-endorsed measures against the cost charged to payers by 15,000 primary care, specialist, and surgical providers. The resulting scatter plot showed a mass of random points with only a slight congruence along a diagonal cut.
So if there’s no correlation between spending more and improving outcomes, how can those involved in quality of care actually help patients? The researchers further dived into that segment of providers with above average quality scores and below average costs and found the trick to the trade was really quite simple: care. The other half of the now ubiquitous phrase “quality of care” is really quite simple, quite archaic, and no bells and whistles necessary. Simply care.
The holy grail of improved health outcomes is a simple, old-fashioned skillset including listening, supporting, and being responsive.
In practice it goes by many names: care coordination, care navigation, case management, health coaching, to name a few.
As it turns out, the Stanford study is not the only one to reveal this simple recipe for success. According to findings in HIRC’s Quality of Care: Models and Metrics Service reports, payers express the same set of skills needed from manufacturer account managers and care management teams: listening to payer needs, being knowledgeable about quality initiatives and coordinating their support offerings with the plans’ quality score performance needs. They even express interest in receiving support that helps their staff develop those same skills so they can better serve their patients and increase patient and provider engagement in quality.
Stay tuned for our research update next week to see how manufacturers can support payers’ in achieving those health outcomes and quality scores, and don’t be surprised to see care has a significant role to play.
