Proving Performance

Increasingly, provider organization executive teams are competing for consumer referrals and health plan contracts based on performance. But the question is what performance metrics—and how to communicate them? And how do those performance measures translate into payment for performance?

Consumer are looking for ready access, a great experience, and low out-of-pocket costs (see Planning A Digital Consumer Experience and Why Do Consumers Not Come Back? (Or Not Show up?). Health plans are looking for improvement in their HEDIS and CMS Stars scores and lower emergency room (ER) use and readmission rates (see HEDIS & More and Behavioral . . .