Tuesday, November 18, 2014

Quality Reporting Problems

Meeting "quality metrics" is not the same as providing actual quality medical care. From Dr. Arvid Cavale at Rebel MD: "The Physician Quality Reporting game hurts patients, physicians alike".

One money quote from Anders Gilberg of Medical Group Management Association (MGMA):
Medicare has lost focus with its physician quality reporting programs. Instead of providing timely, meaningful, and actionable information to help physicians treat patients, this has become a massive bureaucratic reporting exercise. Each program has its own set of arcane and duplicative rules which force physician practices to divert resources away from patient care .
In many ways, the various quality metrics are like the push for aggressive standardized testing in public schools.  The standardized tests may not reliably capture whether or not a school provides actual good education. And school districts can be tempted to "teach for the test" at the expense of doing what's best for their students.

Dr. Cavale's bottom line:
Medicine is a highly personal and individual profession, with incredible variation across specialities, regions and populations in our diverse country. All centrally planned and dictated methods, do not and cannot, provide evidence of quality of care. It is obvious to any observer that these attempts are simply methods to collect data, gain control over physicians and provide rationale for payment reductions...