Physician reimbursement increasingly depends upon measures of healthcare quality. Physicians who fall short on quality measures now face financial penalties. But it might be quality measures, themselves, that are falling short, according to a study conducted by the American College Physicians.
The study involved a panel of people with expertise in evidence-based medicine. Panelists were asked to evaluate the validity of quality measures being used by either Medicare, the National Committee for Quality Assurance, or the National Quality Forum. It is typically measures from these three groups that are used to determine physician quality report cards, and Medicare plans to use its measures to influence reimbursement for individual clinicians.
The panel evaluated the validity of these measures using a modified version of a RAND/UCLA method that has been widely accepted as the best way to assess the strength of evidence for healthcare interventions. That method, developed in the 1980s, combines literature review and synthesis, multiple rounds of expert panel ratings, and retrospective comparison of evidence with clinical records, when feasible. The method isn’t perfect. But its the best we’ve got by a long shot.
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