AQA Pilot Seeks Best Approach to Data Collection, Reporting

The Ambulatory Care Quality Alliance, a broad-based coalition seeking to improve health care quality and safety in the United States, recently announced it had selected six sites for a pilot project designed to test how to collect and report data on physician performance.

The pilot, which is being funded by CMS and the Agency for Healthcare Research and Quality, will mark the first time that a combination of public and private information is being used to test approaches to measuring and reporting these data publicly.

Academy EVP Douglas Henley, M.D., a member of the AQA steering committee, said the pilot project is an important step "because it focuses on two critical areas where more information is needed in assessing physician performance."

First, said Henley, we need to learn how physician offices can best implement performance measures in a way that will improve quality of care. Second, how can we aggregate such data across all payers so that the data fairly and accurately reflect the care of all patients with the conditions that are being assessed?

"The pilot sites include a number of small and medium-size practices," said Henley. Practice size has been an obstacle to measuring physician performance accurately because some practices may not have enough patients with a certain disease, such as asthma or diabetes, to allow for meaningful calculation of quality data.

This pilot addresses the numbers issue by allowing the aggregation of data from various health plans a physician contracts with, thus increasing the numbers of that physician's patients in specific disease categories to the levels needed for accurate assessment of clinical quality relative to those conditions, said Henley.

The six sites chosen to participate in the pilot are the

- California Cooperative Healthcare Reporting Initiative, San Francisco;
- Indiana Health Information Exchange, Indianapolis;
- Massachusetts Health Quality Partners, Watertown;
- Minnesota Community Measurement, St. Paul;
- Phoenix Regional Healthcare Value Measurement Initiative, Phoenix; and
- Wisconsin Collaborative for Healthcare Quality, Madison.

According to a March 1 AQA press release (MS Word File: 1 page / 61 KB. More about downloading files.) results of the pilot will provide a national framework for performance measurement and public reporting.

"Consumers need and want more useful information to get better care at a lower cost," said CMS Administrator Mark McClellan, M.D., Ph.D., in the press release. "Thanks to strong local leadership and a broad national partnership, this pilot project will bring together information from the private and public sectors to provide a clear picture of quality and cost for the ambulatory care providers in a region."

The AQA was founded in September 2004 by the AAFP, American College of Physicians, American's Health Insurance Plans and AHRQ and currently has more than 125 supporting organizations. Last fall, AQA endorsed a starter set of 26 primary care quality measures targeting eight clinical areas. Since that time, according to AQA, insurance companies have begun to work with network physicians and physician group practices to incorporate those measures into their contracts.