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Trustees Newsletter Articles
Measures Need to Be Consolidated

Quality A recent study published in Health Affairs showed that physicians are spending $15.4 billion per year tracking and reporting quality measures to private insurers, Medicare and Medicaid.

The figures are disturbing, if not completely surprising. The results, from a national survey of cardiology, orthopedics, primary care, and multispecialty practices, showed that an average of 15.1 hours per physician per week were spent developing and implementing data collection processes, entering information relevant for quality reporting into patient medical records, and collecting and transmitting data. The average cost to a practice for spending this time is $40,069 per physician per year. Eighty-one percent of surveyed practices reported that the effort they spend on quality measures is "more" or "much more" compared to three years ago, but only 27 percent believe that the measures moderately or strongly represent their quality of care.

"There is much to gain from quality measurement, but the current system is far from being efficient and contributes to negative physician attitudes toward quality measures," wrote the study's authors, which included researchers from Weill Cornell Medical College and representatives of the Medical Group Management Association. This is a concept we hear often—the burdensome and inefficient nature of reporting multitudes of "quality" measures that often overlap or conflict.

The real question is whether there is any chance that this situation will improve. It's easy and understandable to be skeptical about these kinds of things—I find myself there often—but I do think there is some reason for hope.

Last month, the Centers for Medicare & Medicaid Services and America's Health Insurance Plans, as part of a broad Core Quality Measures Collaborative of health care system participants, released sets of clinical quality measures in seven areas: Primary Care; Cardiology; Gastroenterology; HIV and Hepatitis C; Medical Oncology; Obstetrics and Gynecology; and Orthopedics. The guiding principles used by the Collaborative in developing the core measure sets were that they be meaningful to patients, consumers and physicians, while reducing variability in measure selection, collection burden and cost. The goal is to establish broadly agreed upon core measure sets that could be harmonized across both commercial and government payers.

Whether these agreed upon measures are the start of a solution to this difficult problem remains to be seen, but they seem to be a good start.