Physician Data Drive Quality Improvements

CMS has moved one step closer to implementing a Medicare quality improvement program that will use physician performance data from public and private payers to drive quality improvements in the Medicare program.

In February, one of the agency's quality improvement organizations, the Delmarva Foundation for Medical Care, signed subcontracts with four regional health care collaboratives to start combining Medicare data with information from other payers -- including private payers -- to produce data on the performance of physicians within the Medicare program. Those four collaboratives are

In the near future, CMS will sign agreements with two additional subcontractors, the last step needed to start the Better Quality Information to Improve Care for Medicare Beneficiaries, or BQI, project, which will publicly report physician performance information from multiple sources for the first time, according to CMS. Historically, each individual payer has measured physician performance on its own and then decided whether to publicly report that information.

The aggregated information will "give Medicare beneficiaries a broad overview of provider performance, resulting in better choices in meeting their health care needs," said CMS Acting Administrator Leslie Norwalk, in a Feb. 15 press release from the agency. With those data, physicians will have a more comprehensive view of the quality of care they provide, which will enhance their ability to improve performance, according to CMS.

The BQI project is part of the Bush administration's efforts to develop value-driven transparent health care in the United States. It will test ways to merge data from different payer sources, provide methods for aggregating data from different payers and demonstrate means of gauging physician performance, CMS said.

But David C. Kibbe, M.D., M.B.A., senior advisor at the AAFP's Center for Health Information Technology, said the "government is far from putting in place an accurate and reliable quality performance measurement system for physician care."

"Until we can pull quality and performance data accurately from information systems that physicians use in their practices -- whether they are registries or electronic health records or combinations or both -- then it is going to be really difficult to do any quality performance measurements at the practice or individual physician level," Kibbe said in a recent interview.

The BQI project will apply national consensus-based measures adopted by the AQA alliance, an alliance of health care providers, health plans, senior groups, employers and unions that played a role in establishing the subcontracting collaboratives. The AAFP is a founding member of the AQA alliance.