Value-based purchasing paradigms for facial plastic surgery.

The United States spends more per capita for health care than any other nation in the world. Unfortunately, this expenditure has not necessarily translated into improved patient outcomes. Technological advances coupled with an aging population have contributed to a steady increase in health care spending, projected to have reached $2.5 trillion in 2009. Until recently, facial plastic surgeons have not given attention to value-based purchasing and pay-for-performance paradigms, perceiving these quality agendas as primarily applicable to primary care physicians and chronic disease management. As the use of quality measure factors in physician reimbursement schemes for primary medical care becomes more prevalent, it is imperative that surgical specialists have better insight and knowledge of these trends and their impact. This review will define quality and outcomes parameters in conjunction with an analysis of how outcomes may, in the future, be attached to reimbursement for facial plastic surgeons. Illustration of common facial plastic surgery procedures and potential quality/outcome/performance schema will highlight key elements to assist these surgeons in preparing for the transformation of the health care system to quality and outcomes metrics.