Value-driven health care: implications for hospitals and hospitalists.

There is increasing concern about the quality and cost of health care delivered in the United States. This has led to a focus on value-driven health care, meaning how we can achieve better quality outcomes per dollar spent on health care. Since a large percentage of costs and patient outcomes are directly related to care received in the hospital, the focus on value-driven health care by policymakers and payers is likely to increasingly impact hospitals and hospitalists. Hospitalists can play an essential role in leading and facilitating programs to improve hospital system performance. There are many government initiatives and policies focused on improving quality and value with major implications for hospitals and hospitalists, including: value-based purchasing, quality and cost reporting, Medicare demonstrations, hospital-acquired conditions, incentives for use of effective health information technology (HIT), and the Physician Quality Reporting Initiative (PQRI). The goal of these programs is to reward hospitals and physicians who achieve high-quality, efficient care. As our system and its incentives continue to progress toward alignment with value-based high-quality care, hospitalists should lead change and facilitate solutions to transform our health care system to one that provides high-value care to all. Copyright 2009 Society of Hospital Medicine