The American Hospital Association in a letter to congressional leaders offers numerous suggestions for improving quality measurement programs for Medicare and pay-for-performance programs.
The letter to Rep. Dave Camp, chair of the House Committee on Ways and Means; and Sen. Max Baucus, chair of the Senate Finance Committee, is a response to lawmakers’ request for comments about alternative Medicare physician payment methods, removing barriers to clinical integration of providers and medical liability reform, as well as improved quality measures. AHA recommends:
* Align quality measurement programs with broader national quality improvement priorities for all providers. The volume of measures and disparate ratings has become overwhelming.
* Require measures in quality reporting and P4P programs to be endorsed by the National Quality Forum. This would focus attention on the most critical areas for improvement and encourage coordination of efforts among all providers.
* Align behavioral health quality and payment programs with the reform law-mandated national quality strategy.
* P4P should assess multiple aspects of care and use incentives that recognize providers for both achievement against national benchmarks and improvement against baseline performance to provide greater incentive for improvement.
* Measures should be added to P4P in a gradual, step-by-step process that includes review and endorsement by the National Quality Forum. Measures should be included in a national public reporting program for at least a year before being included in a P4P program. And, monitoring of a measure’s performance should continue through its use in a P4P program.
The complete AHA letter is available here.
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