CMS is wrapping up an agreement with the AMA to use a set of physician-developed clinical quality assessment tools for a Medicare demonstration project to determine the effectiveness of physician performance measurement.
Thomas Sullivan, M.D., newly installed president of the Massachusetts Medical Society, says CMS and AMA officials are in the "final stages of negotiation" on a plan to test Core Physician Performance Measurement Sets, lists of physician performance benchmarks compiled by a coalition of specialty medical societies.
Sullivan, a cardiologist with Women's Health Center of the North Shore, Danvers, Mass., an affiliate of Boston-based Partners HealthCare System, is participating in the creation of the measures. "In the next week or two, they are going to make an announcement," he says of CMS, though he cautions that negotiations have been "complex" to this point.
CMS confirms that the AMA deal will allow the Medicare agency to test performance measurement sets for at least eight specific chronic conditions and ambulatory treatment regimens under its Doctors Office Quality (DOQ) project.
Sullivan calls the collaboration between private medical societies and the government agency "a tremendous victory for organized medicine."
CMS will use measurement sets for adult diabetes, cardiac failure, chronic stable coronary artery disease, hypertension, major depressive disorder, osteoarthritis of the knee, prenatal testing and preventive care and screening. Preventive care and screening includes adult immunization for influenza, colorectal cancer screening, problem drinking, screening mammography and tobacco use.
The Physician Consortium for Performance Improvement--made up of HHS and more than 60 national specialty and state societies and coordinated by the AMA--has completed and published these measures and is working on sets for asthma and community-acquired pneumonia, the AMA says.
According to AMA literature, these measures are "available for testing and demonstration projects."
When it announced the DOQ project last fall, CMS said it would study data from 300 physicians and their patients in Iowa, California and New York to determine the effectiveness of various strategies for measuring clinical quality, systems of care and patient experiences. That test is set to begin this summer and CMS says it plans on completing by July 2005 an evaluation of whether various measures can help clinicians determine how well they provide care to Medicare beneficiaries.
"The three-year project will develop a model for measurement and improvement of quality of care for chronic disease and preventive services at the level of the individual physician/medical offices," CMS says in a March 2003 fact sheet.