Gail Wilensky, PhD. The JAMA Forum 6/19/2018

• “Although the total number of health care measures in use in unknown, some 1700 reportedly are used by the Centers for Medicare & Medicaid (CMS) alone.”
• “the American Health Insurance Plans, CMS, commercial plans, Medicare and Medicaid managed care plans, purchasers, physician groups, other care provider organizations, and consumers have worked in a Core Quality Measures Collaborative to reach a consensus on a set of core measures.”
• “MedPAC recommends the use of a “Voluntary Value Program,” where … withheld payments can be earned back on the basis of population-level measures (such as mortality or hospital readmission rates)….”
• “Given the proliferation of quality metrics currently being collected, it is time for CMS to reconvene the various stakeholders—including patients—to extend the agency’s efforts on developing a uniform set of metrics to be collected from clinicians and institutions.”
• “the quality metrics in use are primarily “micro” in their orientation and are frequently more focused on complications or errors associated with an event such as an episode of illness or a treatment. In contrast, a more fully outcomes-focused assessment would include whether a selected treatment was the most appropriate intervention, given the patient’s condition; whether a diagnosis was clinically accurate; or whether a treatment actually improved the patient’s health, particularly in ways that are important to the patient.”