Measuring quality in the U.S. healthcare system is “clearly out of control” and in need of major reform, according to a report from the Healthcare Association of New York State.
The group evaluated the number of measurements providers must keep track of to meet the requirements of private health insurers, accountable care organizations, the federal government and other entities. They identified more than 2,100.
The volume of measures that exist, promulgated by lack of alignment and poor coordination, has created an environment of measure madness, “Consuming precious resources that could be directed toward meaningful efforts to continuously enhance quality and patient safety,” the report states.
The “measurement madness” may be doing more harm than good, according to the report. It's the latest in a growing number of reports urging consolidation and standardization among the various groups that require reporting of healthcare quality and safety data.
A study published in March estimated that the time providers spend entering data into the electronic health record, keeping track of newly introduced measures and creating protocols to track and report them cost the nation about $15.4 billion a year. Others have noted the quality metric stress that arises as providers face increasing financial penalties for poor performance.
In terms of the measures required to be tracked, HANYS identified 33 for accountable care organizations, more than 100 for the delivery-system reform incentive payment (or DSRIP), 546 for private health plans, 635 endorsed by the National Quality Forum, and 850 from the CMS. Just this week the CMS delayed posting a new hospital quality rating amid pressure from Congress and industry stakeholders who said there was confusion over the measures used.
HANYS urges stakeholders to jointly commit to the minimum number of measures needed to evaluate healthcare quality, align them with national, standardized, evidence-based data, and focus on efforts that target the most vital aspects of care.
