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Physicians See a Gaping Hole in the Safety Net

Joe Cantlupe, for HealthLeaders Media, June 27, 2013

Trying and failing to meet the benchmarks for government quality programs often leaves healthcare safety net programs in the lurch for funding, Serota says.

Serota is blunt in his call for reform, telling me that existing government measurement for quality hasn't been "about truth."

"As we should be moving toward more patient-centered care and population health, we need to be thoughtful about what we measure and why we measure it," Serota told me. "There [are] a lot of reasons for our current quality measures. They were based on several criteria, things that can be measured easily, and measured by claims data and not by truth."

Serota and co-authors expressed their concerns about quality target measures for population health management of the at-risk population in a June commentary in the Journal of the American Medical Association.

While traditional quality measures may be suitable for the commercially insured population, they may not be suitable for patients who need safety net care.

For instance, Serota says that traditional quality measures such as colon cancer screening are legitimate in mainstream hospitals. But healthcare facilities serving impoverished patients have difficulty enrolling patients in such programs because the patients have more pressing concerns, such as chronic illness, or drug and alcohol addictions.

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