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Is There Value in VBP?

John Commins, for HealthLeaders Media, August 13, 2012
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Marlene Weatherwax

CFO and vice president
Columbus (Ind.) Regional Health

We are an independent single-hospital health system and I believe we have a good outlook for the organization. We have strong financial statements, good results, high quality, and improving patient experience. We used to be at the top of the game before HCAHPS came into play and we are working on getting back on top.

Why would it fail? I don't know how to answer that one. We are pretty close to the Indianapolis market and there is a lot of posturing going on by the large health systems. I would contend that Indianapolis is a little overbuilt with specialty hospitals, so everybody is fighting for market share. When they have a difficult time in their own market, they start looking outward. Our pockets are only so deep, where some of their pockets are a little deeper.

I don't know that in and of itself value-based purchasing is doing anything to improve quality while reducing costs, but it is getting people to focus on these things. By using very process-oriented metrics, it is forcing hospitals to look at better types of process improvement methodologies, such as Lean and Six Sigma. I think that by going through that, they will improve their quality and costs, but I don't think that value-based purchasing as it is designed will really cause that to happen on its own. 

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