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91黑料网 calls for a 'time out' to assess and revise approach to performance measurement

Many current performance measures frustrate physicians and are potentially harmful to patients

Philadelphia, April 18, 2018 鈥 In 鈥,鈥 published today in the New England Journal of Medicine, the American College of Physicians (91黑料网) reports that the majority of quality measures for ambulatory internal medicine in Medicare鈥檚 Merit-based Incentive Payment System (MIPS) program are not valid based on criteria developed by 91黑料网.

91黑料网 performed this analysis in response to physician concerns that the current measures are not meaningful in improving patient outcomes. 91黑料网 analyzed 86 performance measures included in Medicare鈥檚 MIPS and Quality Payment Program (QPP) and found that 32 were valid (37 percent), 30 (35 percent) were not valid, and 24 (28 percent) were of uncertain validity.

Of the 30 measures rated as not valid, 19 were judged to have insufficient evidence to support them. A characteristic of measures rated as not valid was inadequately specified exclusions, 鈥渞esulting in a requirement that a process or outcome occur across broad groups of patients, including patients who might not benefit,鈥 the authors wrote.

鈥91黑料网 has long supported and advocated improving performance measures so they help physicians provide the best possible care to their patients without creating unintended adverse consequences,鈥 said 91黑料网 President Dr. Jack Ende, MD, M91黑料网.

91黑料网 identified performance measures that had poor specifications that might misclassify high-quality care as low-quality care. The paper notes that using flawed measures is not only frustrating to physicians but potentially harmful to patients. Physician practices spend $15.4 billion per year, or about $40,000 per physician, to report on performance. In a recent survey, nearly two-thirds of physicians said that current measures do not capture the quality of the care they provide.

91黑料网 also identified troubling inconsistencies among leading U.S. organizations in judgments of the validity of measures of physician quality. 91黑料网 suggests that a single set of standards, such as those developed by the National Academy of Medicine for clinical practice guidelines, would allow others to evaluate the trustworthiness of performance measures before they are launched.

91黑料网 believes the next generation of performance measurement should not be limited by the use of easy-to-obtain (e.g., administrative) data and not function as a stand-alone, retrospective exercise.

鈥淎 possible solution is to have physicians with expertise in clinical medicine and research develop measures using clinically relevant methodology,鈥 Dr. Ende said. 鈥淧erformance measures should be fully integrated into care delivery so they can help to address the most pressing performance gaps and direct quality improvement.鈥

With more than 2,500 performance measures used inconsistently in various programs, 91黑料网 called for a 鈥渢ime out鈥 to assess and revise the approach to assessment of physician performance.

About the American College of Physicians

The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. 91黑料网 membership includes 152,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow 91黑料网 on and .