Healthcare metrics just got a little easier to understand

Health systems have been faced with trying to make sense of thousands of different healthcare metrics, but according to a recent article published by the Journal of the American College of Radiology, a recent compromise has helped cut down on a lot of that confusion.

Michael J. Pentecost, MD, of Magellan Health in Columbia, Md., examined the situation in depth, pointing out that CMS alone has 1,700 different healthcare metrics. Meanwhile, the National Quality Forum has more than 600, the National Committee for Quality Assurance has more than 80, and the Joint Commission has more than 50.

“Looking from a different angle, through its six different programs, the US Department of Health and Human Services has 61 metrics assessing just one condition, smoking cessation effectiveness, as well as 113 for human immunodeficiency virus infection, 68 for perinatal health, and 19 for obesity,” Pentecost wrote. “And the proliferation is not without administrative and financial burden. Health systems claim that some have as many as 50 to 100 full-time employees, at a cost of $3.5 million to $12 million a year, to comply with reporting expectations of payers and accrediting bodies.”

Pentecost explained that, in 2015, the Institute of Medicine of the National Academy of Sciences put together a group to assess the large number of metrics, recommending a trimmed-down list of just 15 metrics for providers to focus on: well-being, life expectancy, overweight and obesity, unintended pregnancy, addictive behavior, health communities, care access, preventive services, patient safety, care match with patient goals, evidence-based care, personal spending burden, individual engagement, population spending burden, and community engagement.

Many, but not all, of the 15 recommended metrics directly impacted radiologists.

“Many of these metrics are most relevant to primary care (well-being, community engagement), but others are central to diagnostic imaging (preventive services: breast and colorectal cancer screening) and interventional radiology (patient safety: wrong-sided procedures and vascular access infections),” Pentecost wrote.

Pentecost said opinions vary on the necessity of guidelines, but a compromise was reached in 2016 between CMS and commercial health plans. CMS went from its 1,700 metrics to seven “foundational metrics” that would be recognized as “value enhancing performance measures”: primary care, cardiology, gastroenterology, human immunodeficiency virus and hepatitis C, medical oncology, obstetrics and gynecology, and orthopedics.