Physicians See a Gaping Hole in the Safety Net
Over the years, Alta Med has invested large sums in putting together quality programs, especially through expensive IT platforms to improve data collection for higher quality and improved reimbursements. Yet Alta Med sees differences in data points it views as important compared to the government, when it comes to a needy population.
When physicians sought to increase screenings for colon cancer, Alta Med struggled. The screening rates were almost 20% below target, according to Serota's report. The doctors tried different ways to attract patients to screenings, such as outreach campaigns and electronic reminder systems. As healthcare officials struggled with screening targets, they wondered about the ROI – financially, and for patient care, Serota says.
"Although we fully appreciate the value of colon cancer screening (one of us had almost 100% compliance rates previously in private practice,) we weren't certain that focused outreach to improve our rates was the best use of staff time," Serota wrote in the JAMA commentary. "In order for our case managers or referral specialists to dedicate efforts to promote colon cancer screening, they would need to spend less time doing something else."
Too often, traditional quality measures such as cancer screening rates and process measures for diabetes care, are "non-patient centric and may result in the redirection of precious resources away from the services patients most need and toward services that are tracked in quality reports," Serota and his colleagues wrote.
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