From How Many to How Well

In 2005 a decision made by the Centers for Medicare and Medicaid Services (CMS), the U.S. government program that pays the provider, again changed everything.1 No longer would a physician’s income be determined by how many patients a physician could treat in the least amount of time. CMS decided quality of care along with efficiency is what would matter most. Essentially, CMS shifted the medical payment system from one based on the volume of services provided, to a system based on the “quality and efficiency of care,” or value-based purchasing (VBP). Patients’ opinions of their doctors now mattered. Patient safety mattered. Quality of care and outcomes mattered. As a result, collaboration between providers and other healthcare stakeholders mattered and mindsets had to change. Coaching provides a vehicle to help facilitate these changes.

There are four business imperatives supporting the foundation of the VBP system: patient medical outcome success, clinical quality, patient safety and system efficiency.

1. Patient Medical Outcome Success

Physician knowledge of the patient and patient trust of the physician strongly correlates with patient adherence to the physician’s recommended treatment.  In practical terms, the physician who treats the patient as a “whole” person yields a strong bond that translates into the patient being up to three times more likely to likely follow the physician’s advice.2 Thus, the better the patient adherence, the more successful are the patient medical outcomes.

Beginning in 2013, about 70% of incentive payments driven by the VBP model are determined by clinical processes of care, or “hard data,” because it is quantifiable. The remaining 30% are based on patient experiences, otherwise known as, “soft data,” because it is based on your patients’ subjective opinions. This patient’s opinion poll measures the communication abilities of your physicians and nurses, as well as overall responsiveness of the hospital staff.3