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Proposed framework for patient-centered outcomes-based measures in alternative payment models.

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Patients are crucial for designing alternative payment models (APMs). This study identifies key characteristics for patient-centered, outcomes-based quality measures to improve value-based care.

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Area of Science:

  • Healthcare economics
  • Health services research
  • Value-based care

Background:

  • The healthcare industry is transitioning from fee-for-service to alternative payment models (APMs) focused on value.
  • Patient perspectives have been largely absent in the design of these new payment models.
  • Oncology serves as a case study to address this gap.

Purpose of the Study:

  • To identify essential characteristics of outcomes-based quality measures for patient-centered APMs.
  • To inform the development of future APMs that better align with patient needs and outcomes.
  • To bridge the gap between APM design and patient-centricity.

Main Methods:

  • A mixed-methods approach was employed, including literature review and key informant interviews.
  • Stakeholder work groups engaged in discussions and prioritization surveys.
  • Synthesis of findings to develop a framework for measure selection.

Main Results:

  • Gaps in current APM quality measures were identified, particularly concerning patient-centered outcomes.
  • Key characteristics for effective outcomes-based measures were prioritized through stakeholder engagement.
  • A framework was developed to guide the selection of measures for APMs.

Conclusions:

  • The proposed framework facilitates the development of clinically meaningful, patient-centered, high-value care.
  • Future work may involve broader reviews across therapeutic areas and broader stakeholder consensus.
  • This research is a step towards more equitable and effective value-based healthcare payment models.