Healthcare Quality Metrics 'Abysmal,' Senate Panel Hears
"It is astounding that we don't have agreement on how to calculate the risk of dying in a hospital," Baucus said. "Three different commonly used measures of mortality produce different hospital rankings. So depending on the measure, a hospital could be at the top or bottom of the list."
Added ranking committee member, Sen. Orrin Hatch, (R-UT) "Currently there is so much marketing around provider quality, particularly with regard to hospitals. Everyone seems to be claiming to be the best at something. Many of these claims are based on proprietary data, making it hard for consumers to have an accurate picture of our healthcare system."
Speakers including former Centers for Medicare & Medicaid Services administrator Mark McClellan, MD, said that CMS and NQF should move more aggressively to measuring outcomes instead of processes.
McClellan is director and senior fellow of the Engelberg Center for Health Care Reform at the Brookings Institution.
"Medicare should take further steps to move away from fee-for-service payments and transition to greater use of person and episode-based payments," McClellan said, adding that such proposals could be enacted this year as part of legislation to address the scheduled Sustainable Growth Rate cut to physician payments. For example, physicians could get some of their payment "based on providing care for a patient, not based on a specific service."
That's not the way doctors are paid today, he said. For example, "Oncologists are only paid based on the volume and intensity of chemotherapy drugs that they administer, and not paid for things like setting a registry for their patients." But that can change, he continued. For example, some oncologists are working on "oncology homes" to devote more effort tracking patients' care to help them avoid complications.
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