CMS project to measure physician quality of care

Participating practices could get CME credits, lower liability premiums or public recognition.

By Markian Hawryluk, AMNews staff. March 3, 2003.

Washington -- The Medicare program is beginning to pilot-test ways to measure the quality of care provided in physician offices. But doctors remain concerned about what the program will do with those data.

Under the Doctors' Office Quality project, the Centers for Medicare & Medicaid Services is developing and testing quality measures and strategies to use those measures to help physicians improve patient care. The agency is completing a list of 10 to 20 measures to use in the project. They will focus primarily on chronic disease management and preventive services related to the treatment of diabetes, heart failure, coronary artery disease, hypertension, osteoarthritis and major depressive disorders.

CMS has identified some 300 physicians in California, Iowa and New York who will participate in the three-year pilot, under the oversight of quality improvement organizations. QIOs are already in each state and contract with CMS to perform Medicare quality improvement and education.

Starting this summer, the physician practices will work with QIOs to gauge their performance using the measures and then to use the data to improve, said Barbara Paul, MD, director of the quality measurement and health assessment group at CMS.

"The long-range goal is to see if we can't develop some better strategies to help physicians improve the quality of care in their offices," she said.

But Dr. Paul acknowledges that the pilot has some serious challenges, not the least of which is identifying measures that physicians will accept and that will provide statistically valid data. CMS turned to the Physician Consortium for Performance Improvement, a group of more than 50 national medical specialty societies and government agencies convened by the AMA to help physicians improve quality. The consortium has developed evidence-based clinical performance measures and reporting tools. The CMS project will use some of these measures.