Quality Reporting Measures

A sometimes-heated discussion taking place in New York City around introducing a physician pay-for-performance program into that city’s immense public hospital system speaks to the broader debate around how best to transform U.S. healthcare

The July 16 announcement by the Centers for Medicare & Medicaid Services that nine of the 32 patient care organizations participating in the Pioneer ACO Shared Savings Program were leaving the Pioneer program, with two of them leaving the Medicare Shared Savings Program altogether, was cause for reflective pause. But is the glass half-empty or half-full in this case?

As a key measure of care quality, the patient experience is a focal point of many healthcare provider organizations, yet many of those organizations fail to score well on patient satisfaction surveys despite their efforts to become more “patient focused.” Researchers at Brigham and Women's Hospital (BWH), offer a potential explanation—insufficient support from hospital management to improve the patient experience by engaging physicians and nurses in the process. Their research was published in published in the March edition of British Medical Journal Quality and Safety.

The College of Healthcare Information Management Executives (CHIME) has submitted comments to the Centers for Medicare and Medicaid Services (CMS), expressing concern that hospitals will not be able to put forth complete, accurate quality data via their EHRs. The comments were in response to a request for information (RFI) on hospital and vendor readiness for the submission of electronic quality data, as part of the CMS’ Inpatient Quality Data Reporting (IQR) program.

A Harvey L. Neiman Health Policy Institute study shows that fewer than one in five healthcare providers meet Medicare Physician Quality Reporting System (PQRS) requirements. Those that meet PQRS thresholds now receive a 0.5 percent Medicare bonus payment. In 2015, bonuses will be replaced by penalties for providers who do not meet PQRS requirements. As it stands, more than 80 percent of providers nationwide would face these penalties.