Measuring health care quality and outcomes effectively and efficiently remains a daunting task. Quality measures are largely seen as too process versus outcome focused, substantially irrelevant to patients and insufficiently aligned between and among payers. Measuring care or care quality, ironically, can and does detract from actual care delivery, can have no relationship to spending efficiency and on its own is costly. A recent article published in Health Affairs found physician practices spent over $15 billion in 2014 in reporting quality measures. Concerning the Medicare program's quality measurement activities, MedPAC in a 2014 report to the Congress went so far as to state, "Medicare's current quality measurement approach as gone off the rails."
During this 23 minute conversation Dr. Burstin briefly describes the work of the National Quality Forum (NQF), the work done by the CMS-led Core Measure Collaborative, quality measurement under the CMS proposed MACRA (Medicare Access and CHIP Reauthorization Act) rule, risk adjusting measures for socio-demographic factors, the role of PREMS and PROMS or patient reported experience and outcome measures and correlating care quality and spending or measuring for healthcare value.
Dr. Helen Burstin is the Chief Scientific Officer at the NQF. Prior to serving in her current position, Dr. Burstin was NQF's Senior Vice President for Performance Measurement. Prior to NQF Dr. Burstin was the Director of the Center for Primary Care at the DHHS Agency for Healthcare Research and Quality (AHRQ). Prior to AHRQ, Dr. Burstin was an Assistant Professor at Harvard Medical School and the Director of Quality Measurement at the Brigham and Woman's Hospital in Boston. Dr. Burstin has published more than 80 articles and book chapters on quality, safety and disparities. She was recently selected as a 2015-2016 Baldridge Executive Fellow. She currently is also is a Professorial Lecturer in the Department of Health and Policy and a Clinical Associate Professor of Medicine at George Washington University and serves as a preceptor in internal medicine.
For information concerning NQF go to: http://www.qualityforum.org/Home.aspx
Recent Efforts to Improve Quality Measurement: A Conversation with Dr. Helen Burstin (June 15th)