Monday Musings

Last week I talked about the way that quality measures are now being used as part of physician compensation packages. Reimbursement based, in part, on patient satisfaction is around the corner. How are wound care clinicians going to handle that? We had better start with tracking and rewarding patient satisfaction scores within the wound care clinic.  Quality based compensation is not going to be easy to figure out.  What percent of an incentive should apply to each measure? How many measures should we select? The formula for this can get ridiculously complex if employers attempt to give physicians a cut of the additional money they earn from participating in Meaningful Use, e-prescribing, the Physician Quality Reporting System (PQRS), bundled payments, and performance payments. It makes more sense to keep it simple and start by deciding what portion of physicians’ compensation should be related to quality, and what part by volume or some other measure of “productivity.”  Compensation based on quality metrics will require extra administrative work. The data will be collected by the electronic health record (EHR) and reports will need to be generated and reviewed as part of the process. That means that as you select an EHR, you need to consider how quality measure data will be collected AND reported.

The shift away from volume is going to happen so practitioners might as well get on board the quality train because it is leaving the station.  If you are one of those dedicated clinicians who spends extra time with patients to educate them and who has always prioritized what was best for the patient over your own best interest, this shift will be good for you. While wound care clinicians have a lot of reasons to leave private practice, focusing on quality measure performance now may actually allow a clinician to retain his or her independence.

One thing I know for sure, as a wound care practitioner, I want to be measured on the quality of wound care I provide and not by whether I provided primary care cancer screening. I also want to make sure that the wound care measures selected are good measures of quality and outcome.

If you want to know a group that is getting this figure out, look at this presentation by Darlene Carey, COO of Precision Healthcare, a wound care management company that is leading the way with quality based wound care.