The role of outcomes data in health care reform

The major driver currently behind the health care reform movement is cost containment. An important mechanism of cost containment will be the transferal of financial risk from third-party payers to care providers. This places the risk for managing the care and the dollars at the site where the care is being delivered. However, by the turn of the century, cost will no longer be the major driver. The value or the performance of the health care plan will be the key issue. Measures of performance and value include both quality of care and patient satisfaction. The Veterans Health Administration defines quality health care as "care that is needed; care that is delivered in a manner that is competent, caring, cost-effective, timely, and at minimal risk to the patient and to the providers; and care which achieves achievable benefits." Patient satisfaction comes from the patient recognizing the customer orientation in us as service renders--as caring for our patients. Health care providers must take charge of setting the measures, defining quality, and seeing to it that we as a profession--as a service profession--conform to that definition.