Existing quality measurement is fraught with problems. The current paradigm is largely based on creating an increasing number of quality measures with little awareness of their statistical properties or their susceptibility to gaming. Measures are often uncorrelated with each other and can be collectively overwhelming yet a focus on only a few can leave substantial gaps in measurement.
Despite these issues, measuring quality is increasingly essential as the medical system transforms toward an accountability “value-based” framework. In some cases, providers have an economic incentive to deny care. Patients may lack trust in delivery systems that are less expensive, believing that they simply provide worse care. Public payers need a mechanism to insure payment cuts do not harm patients. The lack of a reliable quality measurement system is a significant impediment to progress. In other cases better quality measurement is needed to support new payment models and patient choice initiatives.
The Quality Measurement area focuses on projects related to development of quality measurement systems appropriate for different uses.
Accomplishments and Collaborations
Ongoing Projects
- Adaptive Quality Measurement. The overarching goal in developing an adaptive quality measurement system is to assure the quality of care is improved or maintained within systems that are moving from fee-for-service care to alternative payment models, such as those participating in accountable care organization (ACO) programs.
Other Activities
- Landrum serves on the NQF Advisory Panel for Measurement
- Landon serves on the NQF Rural Health Committee
- Chernew presented at the NQF Annual Meeting in March 2015 on the role of quality measurement in supporting payment reform and value based insurance design.
Selected Papers and Publications
- McKellar MR, Landrum MB, Gibson TB, Landon BE, Fendrick AM, Chernew ME. Geographic Variation in Quality of Care for Commercially Insured Patients. Health Serv Res. Published online: May 3, 2016.