From the Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston (Dr Kelley); the Department of Pathology, Warren Alpert Medical School of Brown University, Lifespan Academic Medical Center, Providence, Rhode Island (Dr Patil); the Advocacy Division, College of American Pathologists, Washington, DC (Mss Kennedy, Singh, and Peditto); and the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Cardona). Ms Kennedy is currently with the American Society of Clinical Oncology, Arlington, Virginia.
Arch Pathol Lab Med. 2020 Jun;144(6):697-705. doi: 10.5858/arpa.2019-0378-OA.
CONTEXT.—: Quality measures are a cornerstone in measuring physicians' performance within the Centers for Medicare & Medicaid Services' Quality Payment Program (QPP). Clinicians' performance on quality measures and other categories within the QPP determines Medicare part B payment adjustments. Driven by evidence-based clinical practice guidelines, quality measures should focus on high-priority facets of health care, support a desired patient outcome, and address an area with evidence of a gap or variation in provider performance.
OBJECTIVE.—: To meet the goals of the QPP, a broad array of quality measures must be developed that allows pathologists the flexibility to choose activities and measures most meaningful to their practice and patient population while also trying to mitigate the challenges of implementation and data collection.
DESIGN.—: In this second manuscript of the series, we present the development of additional College of American Pathologists-developed quality payment measures for use in the QPP. We also discuss the relationship of quality measure reporting with reimbursement and the challenges with capturing data for quality reporting.
RESULTS.—: The College of American Pathologists identified 23 new measures for quality performance reporting that reflect rigorous clinical evidence and address areas in need of performance improvement.
CONCLUSIONS.—: Development of quality measures is a necessary and ongoing effort within the College of American Pathologists. Increased awareness about pathology-specific issues in measure development and reporting is essential to ensuring pathology's ability to demonstrate value and meaningfully participate in the QPP.
质量措施是衡量医疗保险和医疗补助服务中心(CMS)质量支付计划(QPP)中医生绩效的基石。临床医生在 QPP 中的质量措施和其他类别中的表现决定了医疗保险 B 部分的支付调整。受基于证据的临床实践指南的驱动,质量措施应侧重于医疗保健的高优先级方面,支持预期的患者结果,并解决证据表明提供者表现存在差距或差异的领域。
为了实现 QPP 的目标,必须制定广泛的质量措施,使病理学家能够灵活选择对其实践和患者群体最有意义的活动和措施,同时努力减轻实施和数据收集的挑战。
在该系列的第二篇文章中,我们介绍了额外的美国病理学家学院开发的用于 QPP 的质量支付措施的制定。我们还讨论了质量衡量报告与报销的关系,以及为质量报告捕获数据的挑战。
美国病理学家学院确定了 23 项新的质量绩效报告措施,这些措施反映了严格的临床证据,并解决了需要改进绩效的领域。
质量措施的制定是美国病理学家学院内部的一项必要和持续的努力。提高对措施制定和报告中病理特定问题的认识,对于确保病理能够展示价值并有意义地参与 QPP 至关重要。