The Role of Patient-Reported Outcome Measures in Value-Based Payment Reform

Value Health. 2017 Jun;20(6):834-836. doi: 10.1016/j.jval.2017.02.003. Epub 2017 Mar 22.

Abstract

The U.S. health care system is currently experiencing profound change. Pressure to improve the quality of patient care and control costs have caused a rapid shift from traditional volume-driven fee-for-service reimbursement to value-based payment models. Under the 2015 Medicare Access and Children's Health Insurance Program Reauthorization Act, providers will be evaluated on the basis of quality and cost efficiency and ultimately receive adjusted reimbursement as per their performance. Although current performance metrics do not incorporate patient-reported outcome measures (PROMs), many wonder whether and how PROMs will eventually fit into value-based payment reform. On November 17, 2016, the second annual Patient-Reported Outcomes in Healthcare Conference brought together international stakeholders across all health care disciplines to discuss the potential role of PROs in value-based health care reform. The purpose of this article was to summarize the findings from this conference in the context of recent literature and guidelines to inform implementation of PROs in value-based payment models. Recommendations for evaluating key perspectives and measurement goals are made to facilitate appropriate use of PROMs to best benefit and amplify the voice of our patients.

Keywords: patient-reported outcomes; payment reform; value-based.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost Control
  • Delivery of Health Care / economics*
  • Delivery of Health Care / organization & administration
  • Delivery of Health Care / standards
  • Fee-for-Service Plans / economics
  • Health Care Reform / economics*
  • Humans
  • Insurance, Health, Reimbursement / economics*
  • Medicare / economics
  • Patient Reported Outcome Measures*
  • Quality of Health Care
  • Reimbursement Mechanisms / economics
  • United States