Benchmark Bingo

We all love stories of unsung heroes who are suddenly thrust into the spotlight to be recognized for their selflessness. This viral ad will touch your heartstrings with its portrayal of a man whose life is comprised of little behind-the-scenes heroic gestures for which he never receives a tangible reward. But in reality, have you ever done something for others without so much as a nod or a smile, let alone an exuberant, “Thank you!” or an ad created about your deed?

In the healthcare world, the Triple Aim is driving many decisions about care: with a goal of better care for less money and more emphasis on population health, there are new regulations that attempt to measure outcomes. There are monetary benefits from spending our health care dollars wisely, and penalties for those who are not meeting the benchmarks set to measure outcomes. The goal is shared savings in the Medicare program reimbursements. And that’s as one would expect: a reward for a job well done, and penalties for not making the established grade. However, as in any system, there are lots of variables.

We all know that if you want improvement, you have to measure what it is you are trying to improve. Therein lies the rub. Are we measuring the right thing for all? What about the little niceties and benefits one gets from kindness and follow through? What about the substantive, systemic changes that may result in better service at a lower cost, but not in reaching the established benchmarks? I heard this referred to as benchmark bingo this week while attending the Home Care 100 Conference in Amelia Island, FL. And that conjured up a great image of what it is like in our healthcare at home world.

While I do believe that doing the right thing is most important, what’s the incentive for doing the right thing when it is not going to increase the star ratings? We also need to think in more far-reaching terms to strive for longer range improvements. Perhaps this is the intent of all the innovation projects that are coming out of CMS. As we continue to look for ways to cope with a steadily growing population that will need care at some point, we have to continue to think about what we are rewarding and how that impacts the future of healthcare at home.

In my business, I often stress to my team that I’m looking for results. The means to that end are less important. But if we’re rewarded based on results determined by another – and those results are far different from what we’d achieve by doing the right thing – how do we keep our compass pointed in the direction of right over reward?

It comes down to integrity; as C. S. Lewis describes, “Doing the right thing, even when no one is watching.” While I don’t know what the answer is with regard to benchmark bingo and measuring outcomes for healthcare at home, I do know that in my own life, integrity is everything, and I’m committed to avoiding the easy road in favor of the right one. Whether anyone is watching or not.

Let’s hope that as we develop solutions to our long-term care needs, that we will have a guiding beacon and make the right decisions for all.