 | | Dr. Howard Graman |
As much as we've talked about changes to come in health care over the past few years, some might still seem distant.
Major directional changes like the ones Dr. Sharpe addresses below take time. They can sometimes happen so gradually we don't recognize the magnitude until we're looking back.
In scanning the list of our current and anticipated quality metrics, there's a good example of slow, yet fairly steady change: our culture's use of tobacco. If you're over 40, you might remember choking on secondhand smoke in restaurants, stores, offices or even airplanes.
It has taken 40+ years to effect change in this area. In 1965, more than 40 percent of Americans smoked. Today, about 20 percent do. Smoking is very strictly regulated and ash trays have largely become a thing of the past.
Next week is the Great American Smokeout (November 21). It's an interesting opportunity to look at how far we--as a nation--have come in promoting better health choices. While there's room for improvement--and we, as clinicians, can play an important role in helping to encourage that--it's a good reminder that slow and steady often wins the race.
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Aligning Pay-for-Performance Measures
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by Karen Sharpe, MD
Medical Director, Primary Care
 We've been hearing a lot about Meaningful Use (MU) and have recently been asked to choose at least nine Clinical Quality Measures (CQMs) from a menu of 64 for our Stage 2 MU reporting.
Now we see why. As medicine moves from a volume to value model, our cost and quality scores will become more transparent and our reimbursement dependent upon outcomes - both as an organization as well as individually.
The selection of the 11 MU CQMs shown below was made because all of these measures overlapped with the Pay-for-Performance quality measures required by our health plan contracts and the Physician Quality Reporting System (PQRS) measures reportable to CMS.
These measures will be our focus for improvement efforts in FY14 and beyond if we are to be successful in the new world of Pay-for-Performance medicine and if we are to realize our vision as a high-performing medical group.
- Breast Cancer Screening
- Cervical Cancer Screening
- Colorectal Cancer Screening
- Diabetes: Hemoglobin A1c Poor Control
- Diabetes: Urine Protein Screening
- Diabetes: (LDL) Management
- Use of High-Risk Medications in the Elderly
- Tobacco Use: Screening and Cessation Intervention
- Childhood Immunization Status
- Documentation of Current Medications in the Medical Record
- Controlling High Blood Pressure
We can expect to continue hearing more about MU in the future. In the meantime, more information about MU Clinical Quality Measures for Eligible Professionals is available HERE. Questions? Please contact me or David Killaby.
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