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Joint Commission officers criticize federal outcomes-measures system

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A study in the Annals of Internal Medicine says that few medical-outcome measures being used or considered for federal accountability programs are adequate. Of 10 measures analyzed using four key criteria, only three fulfilled all criteria, and half of the measures met   one or no criteria.

David W, Baker, M.D., the Joint Commission’s executive vice president, and Mark R. Chassin, M.D., president and CEO of the Joint Commssion, wrote: “During the past few years, federal public reporting and payment programs have focused less on measuring processes and more on measuring outcomes, such as readmission, health care-associated infections, and mortality. [O]utcome measures must be chosen carefully to ensure that the outcomes can be influenced by providers and that differences in outcomes are attributable to disparities in the care provided rather than the result of variations in the populations of patients seen.”

As part of their conclusion, they write:

“The [National Quality Forum’s] seminal work in this area is driving the field forward to a better understanding of how best to structure patient-reported outcome measures, capture meaningful information for patients as well as providers, and lay a solid foundation for the use of these measures for accountability. Given the critical importance of these measures, we need to rapidly explore and adapt to novel methods to capture the patient voice, including the use of computer-adapted technology.”


“We believe that the gold standard for assessing a risk-adjustment methodology is to compare the risk factors in the model with the true prognostic factors for the outcome that have been identified in detailed clinical epidemiology studies.”

To read the Annals piece, please hit this link.


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