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Performance measures take on more meaning if you can compare your performance to other organizations. National benchmarks will help your providers set meaningful goals for improvement.
Implementation of Value-Based Purchasing will reward HIGH performance so set goals high but achievable (such as aligning with 90th percentile rates below).
Here are national benchmarks from 2011 Medicare PQRS Experience Report related to Million Hearts cardiac measures and/or prevention measures.
|
Measure
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National Performance Benchmarks (2011)
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PQRS
All EPs
Mean 2011
|
PQRS GPRO Mean 2011
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PQRS GPRO 90th Percentile 2011
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Diabetes High BP Control (PQRS #3, NQF #61)
|
76%
|
68%
|
78%
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Diabetes LDL-C Control (PQRS #2, NQF #64)
|
57%
|
62%
|
74%
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Diabetes Eye Exam (PQRS #117, NQF #55)
|
36%
|
55%
|
68%
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Diabetes HbA1c Poor Control >9% (PQRS #1, NQF #59) Lower rate is better
|
25%
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26%
|
15%
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Hypertension BP Control (PQRS #236, NQF #18)
|
NA
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68%
|
79%
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Ischemic Vascular Disease-Aspirin (PQRS #204, NQF #68)
|
80%
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NA
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NA
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Tobacco Screening & Cessation Counseling (PQRS #226, NQF #28)
|
80%
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NA
|
NA
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Breast Cancer Screening (PQRS #112, NQF #31)
|
50%
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65%
|
80%
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Colorectal Cancer Screening (PQRS #113, NQF #34)
|
44%
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58%
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74%
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Flu Shots for Age 50+ (PQRS #110, NQF 41)
|
43%
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64%
|
82%
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Pneumococcal Vaccine for Age 65+ (PQRS #111, NQF #43)
|
55%
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57%
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81%
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Source: 2011 PQRS Experience Report
Once you select quality measures, use your EHR to measure performance by running PQRS and/or Meaningful Use CQM reports (identified by the NQF number in the table). Give providers their performance rates as well as benchmarks. Tie performance on measures to compensation, not only for providers, but for everyone on the care team.
If you plan to report PQRS as a group, make certain all providers, regardless of specialty, know what care will be measured and reported. Hold all accountable for reviewing and acting on recommended care, even if the action is simply to refer the patient back to the PCP, or to obtain information on the measure from other providers to ensure care has been provided.
Some conditions, such as undiagnosed or uncontrolled high blood pressure, undiagnosed/uncontrolled diabetes, or smoking are so important to overall population health that no provider should ignore them. At minimum, providers could screen for such conditions and refer the patient to the PCP for follow-up.
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