Medical Billing India

Meaningful Unified Quality Measures

The recently released report from the Government Accountability Office (GAO) clarifies that the officials are looking for a much better or more relevant unified quality measures across all the healthcare programs in the country. One of the major reasons for this is that the health plans (both commercial and government), which currently exist in the country, has failed to agree on a standard set of quality measures, which are used to track the health plan.

Reports indicate that the shift towards value-based care might worsen the current scenario and it will even create confusion among patients and healthcare providers. For instance, different health care programs might have a dissimilar benchmark or a different data collection method for a measure, which is seeking to determine the same thing.

In addition to that, asking health care providers to use multiple methodologies in order to track multiple measures might induce certain business or operational challenges, as they will considerably raise the administrative costs for the medical practice. GAO says that the decentralized decision making, lack of meaningful measures, different methods of management and data collection are the reasons for this current situation.

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Government Accountability Office

The decision made by healthcare industry’s movement to include electronic health records has made the data collection process instable. This is because there was no universal standard and it made the data comparing a lot more difficult. In addition to that, the short of a universal data can also lead to the omission of certain important health care data.

The enormous number of quality measures based on which a health care physician can report has allowed health care providers to enjoy the flexibility to find what actually works for the providers. Furthermore, it has also offered flexibility to the payers to decide what measures they want to use. However, this has lead to a situation where each payer decides to consider different measures, which further creates a lot more operational challenges and confusion for the health care providers.

“Although hundreds of quality measures have been developed, relatively few are measures that payers, providers, and other stakeholders agree to adopt, because few are viewed as leading to meaningful improvements in quality,” GAO report says. It is important that officials address this widely concerned issue, as it might result in large confusion if not solved immediately.