Is There Value in VBP?
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Judy Schwartz, MD
Knox Community Hospital
Mount Vernon, Ohio
I don't think it will have an impact on quality because I don't think what they are monitoring is quality. It's more about monitoring processes than things that have been shown to improve quality.
For example, all the VTE [venous thromboembolism] prophylaxis that we are near 100% on, I am not sure that it really prevents anything of significance from a clinical perspective. Or whether or not you think to document after you tell patients they should take aspirin. Patients are already doing it so I don't think it is markedly changing what is going on. It's just improving the documentation, which of itself may be some benefit but I don't think it is much of a quality benefit as stated.
I do think it will help with service delivery. It will make everybody pay attention to that but when you look at it, those scores are already very high. On the other hand, it depends upon what area you are looking at. ED scores, for example, tend to be lower than ambulatory services scores. Inpatient is heavily impacted by what happens in the ED. So, if your ED isn't doing well, your inpatient scores can suffer from that. We are fairly comfortable here in that we don't have the huge volumes they have in large-city EDs, where they have hours upon hours of waiting times.
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