Accountability for Community-Based Programs for the Seriously Ill.

Innovation is needed to improve care of the seriously ill, and there are important opportunities as we transition from a volume- to value-based payment system. Not all seriously ill are dying; some recover, while others are persistently functionally impaired. While we innovate in service delivery and payment models for the seriously ill, it is important that we concurrently develop accountability that ensures a focus on high-quality care rather than narrowly focusing on cost containment. The Gordon and Betty Moore Foundation convened a meeting of 45 experts to arrive at guiding principles for measurement, create a starter measurement set, specify a proposed definition of the denominator and its refinement, and identify research priorities for future implementation of the accountability system. A series of articles written by experts provided the basis for debate and guidance in formulating a path forward to develop an accountability system for community-based programs for the seriously ill, outlined in this article. As we innovate in existing population-based payment programs such as Medicare Advantage and develop new alternative payment models, it is important and urgent that we develop the foundation for accountability along with actionable measures so that the healthcare system ensures high-quality person- and family-centered care for persons who are seriously ill.

[1]  Jennifer E. Moore,et al.  Agency for Healthcare Research and Quality , 2020, Definitions.

[2]  D. Meier,et al.  A Person-Centered, Registry-Based Learning Health System for Palliative Care: A Path to Coproducing Better Outcomes, Experience, Value, and Science. , 2018, Journal of palliative medicine.

[3]  A. Ryan,et al.  Linking Quality and Spending to Measure Value for People with Serious Illness. , 2018, Journal of palliative medicine.

[4]  Helene Starks,et al.  Using Electronic Health Records for Quality Measurement and Accountability in Care of the Seriously Ill: Opportunities and Challenges. , 2018, Journal of palliative medicine.

[5]  A. Kelley,et al.  Identifying the Population with Serious Illness: The "Denominator" Challenge. , 2018, Journal of palliative medicine.

[6]  J. Teno,et al.  Challenges Of Measuring Quality Of Community-Based Programs For Seriously Ill Individuals And Their Families. , 2017, Health affairs.

[7]  D. Meier,et al.  A National Strategy For Palliative Care. , 2017, Health affairs.

[8]  G. Cuckler,et al.  National Health Expenditure Projections, 2015-25: Economy, Prices, And Aging Expected To Shape Spending And Enrollment. , 2016, Health affairs.

[9]  J. Tulsky,et al.  Effect of Palliative Care-Led Meetings for Families of Patients With Chronic Critical Illness: A Randomized Clinical Trial. , 2016, JAMA.

[10]  J. Agostini,et al.  Aetna’s Compassionate Care Program and End-of-Life Decisions , 2014, The Journal of Clinical Ethics.

[11]  J. Teno,et al.  It is "too late" or is it? Bereaved family member perceptions of hospice referral when their family member was on hospice for seven days or less. , 2012, Journal of pain and symptom management.

[12]  G. Hackbarth Report to the Congress: Medicare and the Health Care Delivery System , 2012 .

[13]  C. Goose,et al.  Glossary of Terms , 2004, Machine Learning.

[14]  L. W. Kates,et al.  Discussing religious and spiritual issues at the end of life: a practical guide for physicians. , 2002, JAMA.