How health quality measures became a jungle: Joanne Kenen

Summary: “Quality measures are good, right? We all want our doctors and hospitals to follow best practices and be held to them,” writes Joanne Kenen, health editor at Politico, on the Association of Health Care Journalists blog. “It’s not so simple. Put aside for the moment whether the measure is accurate – we don’t always know or agree on what the best thing is in health care (Exhibit A: mammograms).

Summary: “Quality measures are good, right? We all want our doctors and hospitals to follow best practices and be held to them,” writes Joanne Kenen, health editor at Politico, on the Association of Health Care Journalists blog. “It’s not so simple. Put aside for the moment whether the measure is accurate – we don’t always know or agree on what the best thing is in health care (Exhibit A: mammograms). There’s another quality problem. There too many quality measures. Oodles and oodles of quality measures. I first came to appreciate this a few months ago when I was doing some preparatory conference calls before moderating a panel with hospital and health system executives. They came from a variety of organizations – big, small, urban and rural. But all had some kind of accountable care organization or ACO-like value-over-volume arrangement. All were serious about trying to navigate a changing health care landscape. All took part in Medicare and Medicare Advantage and Medicaid (most had Medicaid managed plans). And, of course, they dealt with multiple private insurers. … Each of these payers had their own quality measures – some overlapping and some mutually exclusive.  I’m not talking about 10 or 20 or 30 measures. They were dealing with 100, 110, 140 or more. They could not possibly meet those standards – or even measure and report their performance in so many sliced and diced ways. I remember wondering – but not getting a clear answer at the time – about how much money and work hours are being spent quantifying quality when the goal was, in part, to use quality to guide us toward a more efficient health care system.” Joanne Kenen, health editor at Politico, Look at how health quality measures have become a jungle,” Association of Health Care Journalists.