Dr Kate Goodrich on Common Sets of Quality Measures

The transition to value-based care allows clinicians to focus on a few common areas instead of multiple measures for different payers, explained Kate Goodrich, MD, director of the Quality Measurement and Value-Based Incentives Group in CMS.

Transcript (slightly modified)

CMS, AHIP, and other organizations have announced 7 core sets of quality measures. How does the implementation of these core sets of quality measures help the transition to value-based payments?

The transition to value-based care isn’t just happening from CMS alone. Commercial payers are also transitioning to value-based care. Think about it, if you’re a doctor in a practice, small or large, and you have a contract with five or seven different payers in your market, plus you see Medicare patients and you see Medicaid patients, you may be responding to multiple different sets of quality measures that aren’t aligned, and think about the burden that puts on you to have to do that.

So if we can get the quality measures for, let’s just say a primary care physician, or an oncologist, aligned across payers, they are responding to all of the same incentives for where they need to improve the quality of care they deliver. That is much more likely to actually lead to improvement in care for those patients, because physicians, anybody, can’t focus on 30 different areas to improve. And if you’re reporting on 30 different measures for five or seven different payers, there’s no way you can actually truly improve in any one area.

But if we can narrow that to a few common areas that are most important for patients and most relevant for doctors, the chances that you actually can significantly improve care for patients goes up dramatically. That is what the transition to value-based care is all about. It’s all about improving outcomes for patients in a more efficient manner, and improving the patient experience. The payers just have to be aligned in those incentives in order for this to be successful.