Leadership: Value vs. volume: Can we pay for quality?

This building pressure can be seen in a series of vignettes. One of those pivotal moments came in September 2009 when a bipartisan group of 28 senators sent a letter to President Obama asking him, as he worked with Congress on reform legislation, to emphasize the need to “realign spending in the Medicare program to focus on providing more value to beneficiaries.” Another moment emerged in summer 2009 when Mayo Clinic, along with several other healthcare organizations, wrote to federal policymakers asking them to reconsider ways to pay hospitals and physicians for value instead of volume. The clinic’s suggestion: Institute a value index that takes quality (e.g., clinical outcomes, safety, or patient satisfaction), divides it by costs, and produces a quotient of value.