Wednesday, September 30, 2015

Guest Post: The next generation of primary care quality measures

- Steve Martin, MD

Nov. 2015 update: Care That Matters published a position paper on quality measurement and health care in PLOS Medicine.

Everybody talks about the weather ... but nobody does anything about it." 
Charles Dudley Warner (1887)

Unlike the weather, there is something that can -- and must -- be done about quality measures. Soon. Here's what's over the next hill:

The Centers for Medicare & Medicaid Services (CMS) is moving towards linking 30% of Medicare reimbursements to the “quality or value” of providers’ services by the end of 2016 and 50% by the end of 2018 through alternative payment models. More recently, CMS announced a goal of tying 85% of traditional fee-for-service payments to quality or value by 2016 and 90% by 2018. Earlier this year, the Medicare Payment Advisory Commission cautioned that “provider-level measurement activities are accelerating without regard to the costs or benefits of an ever-increasing number of measures.”

Where will these measures come from? To realize this vision, America’s Health Insurance Plans (AHIP) and its member plans’ Chief Medical Officers convened leaders from The Centers for Medicare and Medicaid Services (CMS) and the National Quality Forum (NQF), as well as national physician organizations, to form The Core Quality Measures Collaborative in 2014.

This looks to us like the usual policy makers -- not practicing primary care clinicians or patients. That has to change.

Be sure to register now and join is on Thursday October 29th from 1-5 pm at a pre-conference of the Family Medicine Education Consortium (FMEC) on The Next Generation of Primary Care Quality Measures. We'll be joined by representatives of Community Catalyst, the RightCare Alliance, and Dynamed. Dynamed is completing a review of the evidence of current BCBS Alternative Quality Contract metrics and we will share the results at this gathering.

Care that Matters, a group of primary care trainees, clinicians, and faculty, is leading this effort. We'd welcome your joining us. Please see the beginnings of our website here and contact us to join in this work.

In the meantime, please be sure to sign on for RightCare Action Week, to be held this October 18-24. What is RightCare Action Week? Our healthcare system has strayed from its mission: Healthcare that is effective, affordable, needed and wanted by well-informed patients, and especially, free of clinical decisions that are made with financial or business considerations in mind. From Oct. 18 to 24, 2015, people like you across the country will take action to show patients that we have not forgotten what good medical care is. Actions can be as simple as taking a deeper social history or doing a house call.

To recap, please:

1. Join us for The Next Generation of Primary Care Quality Measures on Thursday, October 29th

2. Join Care that Matters for work on metrics that matter

3. Sign on for RightCare Action Week to be held October 18-24

The Next Generation of Primary Care Quality Measures
Held in conjunction with the 2015 FMEC Annual Meeting
DoubleTree by Hilton and CoCo Key WaterPark
Boston North Shore
50 Ferncroft Road, Danvers MA 01923

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