PUP 4931r Lecture Notes - Lecture 58: Organizational Culture
16 May 2018
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ERV Example for One Risk
If...
Hospital risk for a given patient = 25%, and,
Cost of hospitalization would be = $10,000, and
Effectiveness of home care in mitigating hospital risk = 20%,
Then, monthly ERV= $500
(.20*.25*10,000=$500)
Note incentives:
Higher effectiveness=more money
Spending reallocated to highest risk-benefit potential
Process, outcome evaluation criteria implied
Calculating an ERV Budget
For each patient, effectiveness and risk weighted value defined as ERV:
ERVij = Ej*Rij*Vj·
Where:·
ERVij = The Effectiveness and Risk weighted Value of adverse outcome j for
patiet i
Ej=Effectiveness, defined as average change in the risk of adverse outcoe j due
to home care
Rij =Risk of adverse outcome j for patiet i
Vj=Average value of avoiding adverse outcome j
Bottom Line on Quality, P4P & CM
Quality should be measured in 3 dimensions
Structure, process, outcome
Quality in US is pretty bad, and quite uneven
Varies by area beyond case mix, patient preference explanations
Varies by provider style of practice
and supply sensitive services (see variation slides)
Lots of both underuse and overuse
Moving away from unaccountable, volume based purchasing is essential to
improve quality, control excessive use of ineffective procedures and unnecessary
tests & visits (especially to specialists).
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Hospital risk for a given patient = 25%, and, Cost of hospitalization would be = ,000, and. Effectiveness of home care in mitigating hospital risk = 20%, For each patient, effectiveness and risk weighted value defined as erv: Ervij = the effectiveness and risk weighted value of adverse outcome (cid:858)j(cid:859) for patie(cid:374)t (cid:858)i(cid:859) Ej=effectiveness, defined as average change in the risk of adverse outco(cid:373)e (cid:858)j(cid:859) due to home care. Rij =risk of adverse outcome (cid:858)j(cid:859) for patie(cid:374)t (cid:858)i(cid:859) Quality in us is pretty bad, and quite uneven. Varies by area beyond case mix, patient preference explanations. Varies by provider style of practice and supply sensitive services (see variation slides) Moving away from unaccountable, volume based purchasing is essential to improve quality, control excessive use of ineffective procedures and unnecessary tests & visits (especially to specialists). Moving to p4p is a good idea if it is designed carefully and implemented faithfully.
