Makes performance and quality hard to oversee

The approach depends on monitoring activity or quality that is difficult to observe or interpret. This matters most when problems can persist without detection and less when oversight can identify and address them.

Under your mix of paths

Paths that create or worsen it

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Caused or worsened by these paths

A cost these paths share. Each path's page says how it applies there.

Eliminate prior authorization except for a short listPrior authorization delays and blocks careChosen

Retrospective review requires audit capacity.

Tie nonprofit tax exemption to community benefitExecutive pay and nonprofit statusChosen

Tying tax exemption to community benefit requires measuring benefits that are hard to assess and easy to inflate.

Public review of hospital budgetsExecutive pay and nonprofit statusChosen

Public budget review depends on negotiators who cannot judge every line item.

Mandatory error reporting and learning systemMedical errors and poor care coordinationChosen

Adverse-event reporting still leaves some events unreported despite its no-blame design.

Dedicated public health fundingPrevention and public health are underfundedChosen

The results of protected public health spending are hard to see.

Cash benefit option for family caregiversCovering long-term care can pull unpaid family care into the paid systemChosen

Quality is hard to monitor when families receive cash to provide care themselves.