State takes value-based purchasing to the next level

Last month, the Alliance, in partnership with the Washington State Health Care Authority (HCA), unveiled the first set of results for the Washington State Common Measure Set for Health Care Quality and Cost, a set of 52 measures that enable a common way of tracking important elements of health and how well the health care system is performing. Measuring the performance of our health care system is an important step toward identifying where it can be improved, but the HCA is taking the Common Measure Set to the next level, by incorporating 19 of the measures into UMP-Plus, a new benefit option for Washington State public employees in the Puget Sound region.

UMP-Plus includes two clinically and financially accountable provider networks and further accelerates the State’s effort to drive health care market transformation through payment reform. The goal of the Accountable Care Program is to provide “best in class” patient service, integrate physical and behavioral health services and offer high-quality care at a lower cost. The quality of health care services that a provider network provides will be determined by the subset of measures from the Common Measure Set as well as several patient experience measures.

HCA is responsible for approximately one-third of health care spending in Washington state, so its actions send a strong signal to the market of the need to move to value-based purchasing. Value-based purchasing rewards health care providers for value (high-quality care and service at a fair cost) rather than volume. In value-based provider payment, providers bear more financial risk if they perform poorly and share savings if they perform well.

2016 will be an important year for the expansion of value-based purchasing in Washington. The Alliance is pleased to be partnering with the HCA to educate purchasers and consumers about the importance of buying value in health care. For example, our Savvy Shopper series helps purchasers educate their employees and members about the elements of value in health care, which in turn helps support the move to value-based benefit strategies. We’re also pleased to be co-sponsoring, along with the HCA and the Washington Roundtable, an interactive workshop with King County that will help purchasers understand the importance of value-based purchasing and the resources available to them to implement it.

Encouraging value-based purchasing in our state is a long-term journey.  Employers must actively engage because  no single purchaser, no matter how large, will be able to change the system on its own. And purchasers cannot move the market without the strong support of health plans and providers.  However, by working together, we can change the market.  I know I can count on you to lend your support to this important initiative.

Happy New Year!

Published: January 8, 2016

About Washington Health Alliance

The Washington Health Alliance is a place where stakeholders work collaboratively to transform Washington state’s health care system for the better. The Alliance brings together organizations that share a commitment to drive change in our health care system by offering a forum for critical conversation and aligned efforts by stakeholders: purchasers, providers, health plans, consumers and other health care partners. The Alliance believes strongly in transparency and offers trusted and credible reporting of progress on measures of health care quality and value. The Alliance is a nonpartisan 501(c)(3) nonprofit with more than 185 member organizations. A cornerstone of the Alliance's work is the Community Checkup, a report to the public comparing the performance of medical groups, hospitals and health plans and offering a community-level view on important measures of health care quality (www.wacommunitycheckup.org).

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