This issue brief from The Commonwealth Fund examines how health care delivery system reforms might be monitoring and evaluated.  The authors propose documenting and monitoring changes in delivery system structures, capabilities, incentives, and outcomes:

  • Structure:  What  does  it  look  like?  How  is  the   delivery  system  organized, and  how  does  it  change   over  time?
  • Capabilities:  What  can  it  do?  Does  the  delivery   system  have  the  tools  and processes  in  place  that   would  allow  it  to  manage  total  spending  and health   outcomes?
  • Incentives:  With  what  incentives  is  it  provided?   Do  incentives  in  the external  environment  encour-­ age  the  delivery  system  to  contain  costs  and improve  health  outcomes?
  • Outcomes:  What  does  it  actually  do?  Does  the   delivery  system  succeed  at containing  costs  and   improving  health  outcomes?

The authors conclude: “Without  a  clear  understanding  of  what  is  changing  in  the delivery  system,  it  will  be  impossible  to  draw  any   conclusions  about  the  impact  of change  on  cost,  quality,  access,  and  patient  experience.”

Link to Original Source

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