A recent column in Med Page Today by David Nash draws attention to the quality measure development process as well as its funding model by CMS.
My comment in response was not published in Med Page (shocking!), so I thought I’d post it here:
“Thank you for drawing attention to the quality problems in quality measure development. Mediocrity is its own reward in the quality measurement arena. For 7 years we tried unsuccessfully to interest CMS in the development of quality measures (QM’s) relevant to chronic wounds, a problem affecting 15% of Medicare beneficiaries and costing perhaps $96 billion per year.
“We have developed 21 QCDR measures despite the absence of any funding for the work, 14 of which are available for reporting in 2019. Hundreds of wound care practitioners utilize the U.S. Wound Registry (USWR) for MIPS reporting, and are grateful for the availability of QM’s actually relevant to their practice – a rare experience for most practitioners. We have demonstrated that clinicians reporting USWR measures have better wound outcomes. Had we a fraction of Yale’s federal largess, we could demonstrate substantial cost savings as well.
“Moving the needle in patient outcome is not a criterion used by CMS in the annual review of measures, a battle waged with sub-contractors devoid of clinical experience. Unlike many institutions perpetually underwritten by CMS, we are among many small, unfunded organizations striving diligently to leverage an arcane process for the benefit of millions of forgotten patients with unpopular diseases. In the fraught area of quality measure development, we can attest that, ‘We, the unwilling, led by the unknowing, are doing the impossible for the ungrateful. We have done so much, for so long, with so little, we are now qualified to do anything with nothing.’ I begin to wonder if that is an advantage.”