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Tackling the Gordian Knot of Quality Measurement

Orrico HeadshotGuest post from Katie O. Orrico, JD
Director,
American Association of Neurological Surgeons (AANS)
Congress of Neurological Surgeons (CNS)

From time to time on Neurosurgery Blog you will see us cross-posting or linking to pieces from other places when we believe they involve issues that merit highlighting to our readers. Today’s post originally appeared on the Health Affairs Blog and is authored by Patrick Conway, MD, at the Centers for Medicare & Medicaid Services (CMS). Entitled, “,” this blog post is an outstanding summary of the challenges facing specialists and other providers as they grapple with complying with multiple payer quality reporting programs.

Health Affairs BlogOrganized neurosurgery is pleased that CMS and other third-party payers are tackling this important topic. Neurosurgeons and other specialists continue to find a paucity of relevant quality metrics that appropriately reflect the practice of neurosurgery, improve the quality of care and provide patients with useful information. We are bombarded with a multitude of compliance programs that are not integrated — notably the Physician Quality Reporting System (PQRS), Electronic Medical Record (EHR) meaningful use and Value-based Payment Modifier (VM) programs — which largely operate in silos and require physicians to report on inconsistent and irrelevant measures to avoid Medicare payment penalties, rather than improving the value of care provided.

It is high time that all healthcare stakeholders address this Gordian Knot. The passage of the Medicare Access and CHIP Reauthorization Act (MACRA) was a meaningful step forward in the consolidation of Medicare’s quality improvement programs. To this end, policymakers must be mindful not to take the existing flawed programs and mush them together into a new, dysfunctional, system. Such a move must be resisted and we should view the passage of MACRA as an opportunity to hit the quality improvement reset button and create programs that work for patients, physicians, third-party payers and other stakeholders.

Finally, it is essential that the Core Quality Measures Collaborative actively engage with all the specialties, not just those larger groups like cardiology and orthopaedics. Many of these specialties, neurosurgery included, have implemented exceptional quality improvement programs — such as neurosurgery’s (N²QOD) — that should be broadly recognized by all payers as satisfying the various quality reporting requirements.

Neurosurgeons commend Dr. Conway and others in the Collaborative for this effort to bring sanity to the currently insane quality reporting systems and we stand ready to work with CMS to improve our healthcare system.

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