Apples to Apples, Risk Adjusted for Cost & Quality of Care

Cost & quality. Compare & risk adjust. Measurement that serves people is complex, fraught, in its infancy. Chat with Dr. Bob Phillips to make some sense of it.

Cost & quality. Compare & risk adjust. Measurement that serves people is complex, fraught, in its infancy. Chat with Dr. Bob Phillips to make some sense of it.

Proem

This week I compared large screen monitors, care planning apps, clinicians, vacation packages, and high-end chocolate — all efforts of privilege, except the clinicians. I can afford them; I don’t really need them. I actually purchased nothing. Mostly, I’m curious about comparing apples to apples, enough information, marketing to emotion, marketing with facts. I also attended a day-long cost measure meeting, the NQF (National Quality Forum) Cost and Efficiency Measure Standing Committee. This meeting evaluates measures that Medicare uses to compare physicians performing common high-cost surgeries: heart surgery, hip replacement, and spine surgery. Ideally, we compare to find the best quality, lowest cost, and most accessible — whether it’s surgery, monitors, apps, vacations, or chocolate. The more I explore comparison, the less I know. I asked around, and Bill Lawrence at PCORI (Patient-Centered Outcomes Research Institute) referred me to Bob Phillips. Remember that links to organizations, articles, and concepts can be found in the transcript and show notes.

Introducing Bob Phillips

Dr. Bob Phillips is the Founding Executive Director of the Center for Professionalism & Value in Health Care at the American Board of Family Medicine Foundation. Dr. Phillips practices part-time in a community-based residency program and is a Professor of Family Medicine at Georgetown and Virginia Commonwealth Universities. He served as vice chair of COGME (the Council on Graduate Medical Education) and co-chair of Population Health on the National Committee on Vital and Health Statistics. Dr. Phillips was elected to the National Academy of Medicine in 2010.

Health Hats: Bob Phillips. Welcome. Thank you so much for joining us today. I need your help. I’ve been trying to explain, understand myself, this whole issue of comparing clinicians, comparing clinics, comparing institutions…