Guide Designed to Help Hospitals Assess Value-Based Care

The Health Research & Educational Trust and Hospitals in Pursuit of Excellence, both research affiliates of the American Hospital Association, have issued the "Second Curve Road Map for Health Care" guide meant to help hospitals assess their performance on value-based metrics as they shift to new payment models.  The report suggests 19 metrics to meet four value-based strategies prioritized in a previously released AHA report, "Hospitals and Care Systems of the Future," as health care transitions from fee-for-service to pay-for-performance.

Strategy 1: Aligning hospitals, physicians and other clinical providers across the continuum of care
1. Percentage of aligned and engaged physicians.
2. Percentage of physician and other clinical provider contracts containing performance and efficiency incentives aligned with accountable care organization-type incentives.
3. Availability of non-acute services.
4. Distribution of shared savings and performance bonuses or gains to aligned physicians and clinicians.
5. Number of covered lives accountable for population health (e.g., ACOs or patient-centered medical homes).
6. Percentage of clinicians in leadership.

Strategy 2: Utilizing evidence-based practices to improve quality and patient safety
7. Effective measurement and management of care transitions.
8. Management of utilization variation.
9. Reducing preventable admissions, readmissions, emergency department visits, complications and mortality.
10. Active patient engagement in design and improvement.

Strategy 3: Improving efficiency through productivity and financial management
11. Expense per episode of care.
12. Shared savings, financial gains or risk-bearing arrangements from performance-based contracts.
13. Targeted cost-reduction and risk-management goals.
14. Management to Medicare payment levels.

Strategy 4: Developing integrated information systems
15. Integrated data warehouse.
16. Lag time between analysis and availability of results.
17. Understanding of population disease patterns.
18. Use of electronic health information across the continuum of care and community.
19. Real-time information exchange.

The report breaks down these metrics further to measure progress on value-based care.