Healthcare Quality Metrics 'Abysmal,' Senate Panel Hears

Cheryl Clark, for HealthLeaders Media , July 2, 2013

"It is astounding that we don't have agreement on how to calculate the risk of dying in a hospital," Baucus said. "Three different commonly used measures of mortality produce different hospital rankings. So depending on the measure, a hospital could be at the top or bottom of the list."

Added ranking committee member, Sen. Orrin Hatch, (R-UT) "Currently there is so much marketing around provider quality, particularly with regard to hospitals. Everyone seems to be claiming to be the best at something. Many of these claims are based on proprietary data, making it hard for consumers to have an accurate picture of our healthcare system."

Speakers including former Centers for Medicare & Medicaid Services administrator Mark McClellan, MD, said that CMS and NQF should move more aggressively to measuring outcomes instead of processes.

McClellan is director and senior fellow of the Engelberg Center for Health Care Reform at the Brookings Institution.

"Medicare should take further steps to move away from fee-for-service payments and transition to greater use of person and episode-based payments," McClellan said, adding that such proposals could be enacted this year as part of legislation to address the scheduled Sustainable Growth Rate cut to physician payments. For example, physicians could get some of their payment "based on providing care for a patient, not based on a specific service."

That's not the way doctors are paid today, he said. For example, "Oncologists are only paid based on the volume and intensity of chemotherapy drugs that they administer, and not paid for things like setting a registry for their patients." But that can change, he continued. For example, some oncologists are working on "oncology homes" to devote more effort tracking patients' care to help them avoid complications.

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2 comments on "Healthcare Quality Metrics 'Abysmal,' Senate Panel Hears"

Peter (7/4/2013 at 9:06 AM)
Sadly, we're an industry ecosystem that is still largely disconnected and pointing fingers at each other. Without de-humanizing care or de-valuing healthcare professionals, we need to accept that "healthcare" is a supply chain that is, for the first time, getting wired for optimization. Consumers need to be accountable for their health (and costs). Doctors need to care about outcomes and health not visits and billing. Everyone will make EMRs and their affiliate systems (PACS, VNA... Etc.). become more useful and effective when they understand the supply chain of health and how to improve. Then again, I don't even know my blood pressure... So I'll start with me.

Harvey (7/2/2013 at 10:48 AM)
Patients are not always compliant, are they taking the correct meds, are they staying on their restricted diet, have they really stopped smoking, are they keeping their specialist appointments etc.Quality is not a one way street. Congress also decided to let free enterprise have free reign over EMR's and now millions of dollars and an enormous amount of resources are being wasted trying to get EMR's to communicate with each other. Physicians are wasting valuable resources and money chasing after specialist trying to get their patients consults. EMR is a wonderful tool unfortunately American business tainted it and it will take years and years to deliver the product that it should and can be.




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