Measuring what matters: How can homeless health care providers shape the measurement of our performance?

Performance measures not only shape clinical priorities, but also are a high priority for payers seeking to ensure that care is both value-based and patient-centered. In this era of performance measurement, HCH providers face a challenge because their patients' concerns are often unique and the circumstances surrounding care are exceptional. Current measures, on which health centers providers are increasingly paid, are not always relevant to the care of people without homes. For example, rather than evaluating colorectal cancer screening, perhaps measures could evaluate engagement in care or screening for violence and trauma. In this dynamic workshop we will discuss how Central City Concern has developed and selected measures relevant to its population, facilitated by an innovative local payer, CareOregon, a Medicaid managed care organization dedicated to a more flexible and responsive system of value-based payment. We will then review the core components of good health care performance measures (spanning process and outcome measures, as well as measures of quality, cost and experience) and invite workshop participants to design measures most suited to their clinical scenarios. We will conclude with a discussion of how to influence local and national health policy to incorporate these performance measures into payment and incentive programs.