What’s Wrong With Medicare’s Quality Measures?


There are too many quality measures and providers to spend too much time reporting on them, according to a government watchdog report.

The Government Accountability Office (GAO) urged the Department of Health and Human Services to develop more meaningful quality measures and to prioritize the development of electronic quality measures. Electronic quality measures allow providers to report data elements digitally through information collected on electronic health records. The HHS concurred with the GAO's recommendations, the report said.

Recommendations in the GAO report are meant to reduce administrative requirements for providers, who must often spend time collecting and reporting on different quality measures for a variety of public and private payers. The Centers for Medicare & Medicaid Services and private insurers use data collected from quality measure reporting to encourage better patient outcomes and more efficient use of financial resources. However, payers sometimes mandate providers' collection of information on conflicting quality measures, and this misalignment could create administrative burdens for providers.

A hospital industry executive pushed back against the call to rely more heavily on electronic quality measures. Nancy Foster, vice president of quality and patient safety policy at the American Hospital Association (AHA), told me electronic quality measures are problematic for providers. A major problem with using them is clinicians record needed data in different fields in the digital form, which makes it difficult for medical record abstractors to obtain and record the information they need to report, Foster said.

Clinicians also use different wording and/or language to record data needed for reporting on the quality measures, Foster told me. The lack of consistent language also makes it difficult for medical record abstractors to get the information they need. Electronic health records will need to be changed to better cull information from them for quality measures, Foster explained to me.

My full story includes more details about the GAO report and Foster’s reaction to it.

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