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The term “value-based care” is tossed around like a political football among healthcare policy makers. Nowhere is the meaning of this so variable as in nursing homes.
The Nursing Home Value-Based Purchasing Demonstration project, completed over a decade ago, was not found to lower spending or improve quality. Webster’s Dictionary defines value as “the monetary worth of something,” “a fair return or equivalent in goods, services, or money for something exchanged” and “relative worth, utility or importance.”
The government used performance measures such as hospitalization rates and quality measures as a proxy for value. Shouldn’t we be asking how clinicians, patients and their families define value?