Draft Set of Quality Performance Measures Awaits Comments

The selection committee of the National Quality Forum's Ambulatory Measure Project recently sent forward for comment 49 of 100 quality measures it considered in an expedited review process. The proposed evidence-based performance measures address seven areas of care: asthma/respiratory conditions; depression/behavioral health; bone diseases; heart disease; hypertension; prenatal care; and prevention, immunization, and screening.

The NQF is a standards-setting organization whose primary objective is to develop consensus among health care stakeholders about voluntary standardized indicators that can be used to measure and report health care quality. Many of the measures recommended by the steering committee are proprietary measures from AMA's Physician Performance Measurement Set, CMS' Doctor's Office Quality project and measures developed by the National Committee for Quality Assurance.

"National Voluntary Consensus Standards for Ambulatory Care: An Initial Physician-focused Performance Measure Set" has been sent forth for comment. The public comment period ends May 16; NQF members may review and comment on the measures until May 23.

According to NQF statistics, more than a billion patients visit physician offices and hospital outpatient and emergency departments each year. Despite the fact that ambulatory care is the center of health care in the United States, quality measures that evaluate the performance of health professionals providing outpatient care are lacking, says the NQF.

As physician leaders, we should listen for the "thunder in the distance," says Bruce Bagley, M.D., AAFP's medical director of quality improvement and an NQF steering committee member. Family physicians need to know that this process is going on because it's likely that by the end of the year "some of these measures will show up in the marketplace."

Developing meaningful quality measures figures significantly into pay-for-performance discussions, says Bagley. "With pay-for-performance programs erupting across the health care landscape, the time to agree on a common set of quality measures is now."

The Academy's "Pay-For-Performance" policy statement includes a section on performance measurement criteria. The statement says the AAFP supports the development and application of performance measures that are: