Rethinking Quality Measures
Quality measures impact 20% of physician compensation, 40% of health system revenue by 2022. Measures can transform provider culture & self-insured employer costs. Guests: Bernadette Spong, CFO of Orlando Health & Richard Royer, CEO of Primaris.
Quality measures may impact up to 20% of physician compensation and 40% of health system revenue by 2022. Healthcare organizations report quality, process, and outcome measures to government agencies and private entities. In this interview, Orlando Health CFO Bernadette Spong and Rick Royer, CEO of Primaris, explore the strategic implications.
Orlando Health is a large integrated delivery system with 8 acute care hospitals and over 500 employed physicians treating approximately 1.5 million patients per year across acute and ambulatory clinical settings.
Primaris delivers 10,000 monthly quality and registry data submissions on behalf of health systems, physician practices, nursing homes, and accountable care organizations.
Collecting and reporting these data incur significant cost and management oversight. The measures purposely influence clinical and business processes though sometimes with unintended consequences.
Healthcare expenditures have come to be one of the single largest expenses for federal and state government as well as private enterprise, consuming 18% of the overall domestic economy. Reducing healthcare spending trends requires an ability to objectively differentiate good from bad healthcare.
Quality measures are the most widely adopted and available metrics to serve this need. As a result, regulated quality measures have growing strategic implications for a healthcare organization’s mission achievement and financial sustainability.
Measures can also draw attention to the broad impact of individual clinical conditions. For example, patients acquiring Clostridium Difficile during a hospital stay are extremely expensive to treat, often are readmitted, and measurably impact a hospital’s Medicare reimbursement. C. Diff infection rates and outcomes are also directly and indirectly impact reported quality measures.
Even with massive political change in Washington, these data will inevitably grow in strategic importance. Quality measures offer a common method for payers, large employers, and other stakeholders to evaluate health system and physician performance.
For large employers with healthcare spending a top operating expense, quality measures and related registry data are a timely method to drive better care at lower costs.
In this Interview
Richard A. Royer has served as the chief executive officer of Primaris since 2001. He has extensive administrative healthcare experience and is actively involved in several statewide healthcare initiatives. In 2006 he was appointed by the Missouri governor to the Missouri Healthcare Information Technology Task Force and chaired the resources workgroup. He also serves on the board of directors for the Excellence in Missouri Foundation. In his over 35 years of medical business experience he has held positions as chief executive officer at Cuyahoga Falls, Ohio, General Hospital; executive director of Columbia Regional Hospital in Missouri; and founder and president of Avalon Enterprises, a medical financial consulting firm. He graduated from the University of Akron, Ohio, with a BS in Accounting, from Cleveland State University with an MBA, and from the Advanced Management Program of the University of Pennsylvania’s Wharton School of Business.
Bernadette Spong serves as Orlando Health's Chief Financial Officer. She oversees finance, supply chain, information systems, revenue management, asset strategy and care coordination. Orlando Health serves approximately 1.5 million patients through its 8 hospitals and 539 physicians located in central Florida. Prior to joining Orlando Health, served in financial leadership roles for the University of North Carolina HealthCare system.