Public, Private-Sectors Agree on Quality Measures

The Centers for Medicare & Medicaid Services (CMS), and America’s Health Insurance Plans (AHIP), the nation’s leading managed care trade association, have announced agreement on seven sets of quality measures they’ll use to evaluate provider performance in the public and private sectors. Numerous experts, including a recent blue-ribbon panel of The Institute of Medicine, have long argued against the large number of overlapping and sometime contradictory quality measures now in use in the U.S. The goal of the 18-month Core Quality Measures Collaborative was to “establish broadly agreed upon quality measures that will allow for less complexity in reporting for clinicians, decrease the overall cost burden to consumers and the health care system, and ensure high-quality care for patients,” according to an AHIP news release. The seven measure sets address accountable care and patient-centered medical homes, cardiology, gastroenterology, HIV/Hepatitis C, medical oncology, orthopedics, and obstetrics and gynecology. The Collaborative included The National Quality Forum, medical specialty societies, consumer groups and employer representatives. CMS says it is already using a number of the measures but that private payers will take a phased-in approach to implementation, based on the timing of individual contract renewals. For more information, visit www.cms.gov and www.ahipcoverage.com.