Is Too Much Quality a Bad Thing?
They say there can never be too much of a good thing, but in the quality measurement world, too many quality measures get in the way of better quality of care, the National Quality Forum (NQF) is now suggesting. In short, federal healthcare payers and providers are doomed to massive overhead for tracking and data infrastructure (not to mention whole departments of personnel dedicated to improving performance ratings).
Therefore NQF, which is responsible for recommending quality measures to the Centers for Medicare and Medicaid (CMS), is urging Health and Human Services (HHS) to reduce the 240 current measures by 20%.
So why quality measures? Quality measures are a critical component of value-based care and are sometimes used to tie reimbursement to outcomes, such as in Medicare’s various Alternative Payment Models. (Be sure to check out Brooks Primers on Quality and Value-Based Reimbursements for more on that.)
According to Kate Goodrich, CMS Director Clinical Studies & Outcomes, CMO, 5 years of quality-based payments through CMS have resulted in:
- 21% reduction in unintentional harm done to patients
- 125,000 lives saved
- $28B in cost savings
Also, the voice of the patient is amplified by certain measures. While certain public health measures such as immunization rates and care coordination measures tend to focus on process steps, the patient-centered measures are often based on the subjective experience of the patient such as via surveys.
On the other hand, quality measures are critiqued for everything from physicians retiring early to abandoning private practice to join large health systems. This is due to the sunk cost in infrastructure needed to track quality.
However with NQF’s funding up for Congressional reauthorization this year, we’ll be watching to see if the previously reliable push for quality dwindles.