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The Cost of Quality: How Do We Calculate Value-Based Care?

Project Description: Healthcare reform has placed enormous financial pressures on all hospital systems to reduce costs. There is growing interest in surgeon-specific performance measures and patient quality outcomes for a number of individual procedures; several organizations are making great efforts to monitor these surgical metrics. These metrics are aimed at improving performance and quality but they do not necessarily address the issue of reducing cost. A large portion of health care dollars are spent on surgical supplies, diagnostic testing and medications and are used with tremendous variability among surgeons. Currently, there is no standard methodology to establish variations in surgeon cost and the intended impact on patient outcomes. Potential solutions are emerging, but there are few documented, transformative system solutions, and even fewer have been rigorously studied and evaluated for program effectiveness. Simply put, the determination of Value-based care has not occurred. Improvements in health information technology are providing unprecedented ways to measure and monitor cost. Our ultimate principle in this system-wide process is to identify what generates Value, scale solutions that are successful, and modify those that are not. Our project aims include: 1) Standardize real time collection and determination of surgeon cost using the electronic medical records (EMR), 2) Demonstrate the degree of variability amongst surgeon expenses for similar procedures, 3) Identify and demonstrate the source(s) of cost variation, 4) Establish the associated surgeon cost with quality outcomes, 5) Implement system-wide protocols so to reduce cost, maintain quality outcomes and ensure value based care.

Primary contact: Michelle Nguyen, M.D.; Resident Physician, Department of Surgery
Institution: The Ohio State University Wexner Medical Center

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