What role does quality measurement play in assessing the per

What role does quality measurement play in assessing the performance of health plans and in assessing the impact of price competition?

Solution

According to Families USA (2014), quality measurement in health care is the process of using data to evaluate the performance of health plans and health care providers against recognized quality standards.

Quality measures can take many forms, and these measures evaluate care across the full range of health care settings, from doctors’ offices to imaging facilities to hospital systems (Families USA, 2014). Measuring the quality of health care is a necessary step in the process of improving health care quality (Families USA, 2014).

Quality measurement can be used to improve our nation’s health care by:

1) Preventing the overuse, underuse, and misuse of health care services and ensuring patient safety;

2) identifying what works in health care—and what doesn’t—to drive improvement;

3) holding health insurance plans and health care providers accountable for providing high-quality care;

4) measuring and addressing disparities in how care is delivered and in health outcomes; and

5) helping consumers make informed choices about their care (Families USA, 2014).

In all industries, competition among businesses has long been encouraged as a mechanism to increase value for patients (Rivers et al., 2008). In other words, competition ensures the provision of better products and services to satisfy the needs of customers (Rivers et al., 2008). Traditional competition in health care involves one or more elements (e.g. price, quality, convenience, and superior products or services); however, competition can also be based on new technology and innovation (Rivers et al., 2008). A key role of competition in health care is the potential to provide a mechanism for reducing health care costs (Rivers et al., 2008). Competition generally eliminates inefficiencies that would otherwise yield high production costs, which are ultimately transferred to patients via high health service and delivery costs (Rivers et al., 2008).