Our Health Plan by Jim Rickards

Author:Jim Rickards [Rickards, Jim]
Language: eng
Format: epub
ISBN: 9781683502982
Barnesnoble:
Publisher: Morgan James Publishing
Published: 2017-08-01T00:00:00+00:00

CHAPTER 6:

KEEPING ON TRACK—THE THIRTY-THREE METRICS

Albert Einstein had a plaque on his wall that read, “Not everything that can be counted counts, and not everything that counts can be counted.”

I love that, because it’s a good reminder that, even if you’re able to measure something, you want to stay focused on the data and the metrics that matter most. Healthcare is notorious for generating vast amounts of data points. The trick is knowing how to sort through all that and come up with pieces of information that show a difference or can make one.

The CCOs use a set of thirty-three metrics to measure the quality of care delivered, which, when combined with the costs, could show the value of care delivered. In this chapter, I’d like to highlight some of these metrics, because they illustrate the degree to which we’ve been able to increase the quality of care for Medicaid folks and, at the same time, have managed to lower costs in some areas.

I won’t take you through all thirty-three; I could probably write a separate book just on that. Instead, I’d like to walk you through some of the metrics that tell the best stories in terms of the changes the CCOs have brought about.

The starting point is that you can’t just demand performance metrics of people without asking why. There must be a reason for everything you measure. There’s a huge need for medical care, and we’re spending all these dollars. So how do we tell if we’re getting value for what we’re spending money on? Are we measuring the right stuff? Are we measuring things for measurement’s own sake, just so we can say we are measuring things? Are we producing value with all these measurements, or just producing a lot of extra work?

Not only do we have to dedicate staff time to perform the measuring, but we also must create committees to review the data. Is it really worth it? Or should we just keep delivering medical care as we always have?

Four years along in our program, we’ve been able to demonstrate that the thirty-three metrics we’ve created are useful in terms of determining bang for the healthcare buck, if you will. Of the thirty-three, there are seventeen so-called “financial incentive metrics,” where there is actual payment for performance—literally trying to buy better outcomes.

Often, accountants or other people on the financial side of things develop medical metrics. In this case, healthcare providers across the state of Oregon largely determined our financial incentive metrics. What makes these metrics so powerful is that they were developed with considerable input from actual, on-the-ground providers who decided what those metrics should be and how they should be recorded or reported.

Of course, there was a lot of skepticism when it came to trying to measure the results of our efforts. Once, when the CCO was starting up, I was promoting the idea of the CCO to a group of local physicians. I explained how we would better coordinate care, track outcomes, and pay on performance.

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