Examines some of the reasons why establishing a business case for improving health care is so difficult, and considers possible solutions. Includes comments on quality provisions of the Medicare Prescription Drug Improvement and Modernization Act of 2003

David Blumenthal

Timothy Ferris

English

ABSTRACT: The absence of a “business case ” for improving health care quality—evidence that those who invest in quality improvement will see a return on investment within a reasonable time—is widely acknowledged to be a major obstacle to improving health care in the United States. This paper extends the investigation into the causes and possible solutions. Others have previously identified obstacles to creating a business case for quality, among them: the failure of the current health system to pay for quality; consumers ’ inability perceive quality differences; displacement of the benefits of quality improvement; and an administrative pricing system that does not allow purchasers to pay more for higher-quality care. The authors of this report cite five additional root causes: difficulties in changing provider behavior; the primitive state of quality measurement; inadequate health care system infrastructure; major legal obstacles; and fiscal challenges faced by federal, state, and local government. Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and should not be attributed to The Commonwealth Fund or its directors, officers, or staff. Additional copies of this (#715) and other Commonwealth Fund publications are availabl

The Business Case for Quality: Ending Business as Usual in American Health Care

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