No Magic Bullet

Nowhere more than in health care are the stakes higher for quality. That said, neither is there a magic bullet that will make health-care providers more effective, according to Kelly Court, the chief quality officer for the Wisconsin Hospital Association (WHA). Whether it’s preventing readmissions and central-line infections or eliminating sepsis, it is about doing the same four or five things with every single patient, every single time. In this issue, read about how the WHA and its hospital members are exceeding national quality benchmarks; it would not be happening without data transparency and sharing among friendly competitors.

Letting nothing fall through the cracks—care coordination—is another critical tactic in quality improvement. It’s not an easy feat when very sick patients (cancer patients, in particular) are accessing a complex regimen of health care, in multiple settings, from many different specialists. An article in this issue describes the role of patient navigators in connecting the dots for breast- and lung-cancer patients, providing a bridge between inpatient and outpatient settings, and promoting outrageous patient satisfaction (and retention).

Today, we can’t discuss quality without considering cost and our ultimate goal: building value in health care. How do we move the dial on value? Fee-for-service payment is a frequently mentioned culprit in the high cost of US health care, and in response, payors are taking real steps toward putting more of physicians’ incomes at risk, based on meeting quality measures. The final article addresses value-based physician-compensation plans—and, I might add, not a moment too soon. If the sustainable growth rate legislation passes, physicians will have a new acronym to learn: MIPS, for the Merit-based Incentive Payment System.