(As explained on the podcast home page, this is the seventh of eight interviews concerning federal healthcare policy reform. This discussion is with Humana's Dr. Kate Goodrich and was conducted in late December. As you will hear this podcast like all others is introduced by ProMedica's CEO, Randy Oostra. This series was produced in an effort to interest or persuade federal healthcare officials to pursue substantive healthcare policy reform.)
Healthcare quality has been a significant federal policy concern for decades. Despite substantial federal efforts to develop quality measurement and benchmarking performance programming, poor health care outcomes persist, Americans also experience high rates of medical errors that include diagnostic errors, avoidable infections and the mis- or over-use of antipsychotics. Also too, the relationship between healthcare quality and healthcare spending, or value achieved for the healthcare dollar spent, remains largely unknown. The result thereof is that there is significant variation in healthcare spending across geographic regions. For these reasons and related others, MedPAC, in a rare instance of candor stated in 2014, "Medicare's current quality measurement approach is gone off the track."
During this 48 minute interview, Dr. Goodrich begins the discussion by providing an overall assessment of currently quality measurement performance. She discusses the intent behind reforming the the Medicare Part B physician payment program's quality performance program, termed the Merit-based Incentive Payment System (MIPS), to CMS' proposed MIPS Value Pathway (MVP) program, including clinically-related episode based cost metrics, whether quality reporting remain mandatory, discusses how the industry can move to measuring for value or outcomes achieved relative to spending, the use or accounting for socio-economic factors in risk scoring quality measures/performance, discusses patient reported outcome measures (PROMs) and concludes by briefly commenting on including climate crisis health effects in quality measurement and benchmarking.
Dr. Kate Goodrich is Senior Vice President of for Trend and Analytics within the Clinical and Pharmacy Solutions division of Humana, Inc. Prior to coming to Humana, Dr. Goodrich served as the Director of the Center for Clinical Standards and Quality and Chief Medical Officers at the Centers for Medicare and Medicaid Services where she was responsible for 18 quality and value-based purchasing programs, quality improvement programs in all 50 states, development and enforcement of health and safety standards of all facility-based providers across the nation, and coverage decisions for treatments and services for Medicare. Prior to CMS, Dr. Goodrich was on the faculty at the George Washington University Medical Center (GWUMC) and served as Division Director for Hospital Medicine. She continues to practice clinical medicine as a hospitalist and professor of medicine at the GWUMC. Dr. Goodrich earned her undergraduate degree at Rhodes College in Memphis, her MD at Louisiana State University Medical Center in Shreveport, LA and completed her residency training in internal medicine residency training at GWU.
To read a transcript of this interview or to post a comment or question, please go to: https://commissiononhealthcare.org/.