A proposal to include a value index is also included in the Senate healthcare reform bill approved in December. With the Senate provisions, changes to the Medicare payment system would be administered by the Secretary of the Department of Health and Human Services beginning in 2012.
Patient-centered homes. One area receiving extra attention in Washington and throughout the healthcare community this year is the patient-centered home. With this model, patients would spend more time with a primary care provider. In turn, they could receive more personalized, quality care, with an emphasis on prevention and greater patient involvement in medical decision-making.
In 2009, patient-centered medical homes were being tried out around the country. In Washington State, Seattle-based Group Health Cooperative reported its findings on establishing a model in a pilot at its Factoria Medical Center.
The results looked promising—fewer trips to hospital emergency rooms and fewer hospitalizations for conditions that primary care could prevent. But on the flip side, that pilot program found that the number of patients on each physician's panel needed to be reduced and that some additional costs were needed to bring on additional providers.
Patient-centered outcomes. The Senate healthcare reform bill calls for creation of an independent, nonprofit patient-centered outcomes research institute directed by public and private sector representatives to gather research that would help "inform the decisions and patients and providers." The focus would be on the clinical effectiveness of different medical treatments and services for the same conditions.
The Agency for Healthcare Research and Quality would be responsible for disseminating the research findings from this institute and other government-funded sources.
So what will 2010 have in store? It will depend on many things—in part if healthcare reform legislation will be approved at the federal level. But it also will depend on transforming the vision which we have had a glimpse of in 2009—to make quality a definitive part of how care is delivered.