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Quality Forum Endorses Quality Measures for Physician Care

AUGUST 4, 2005 -- The National Quality Forum has endorsed a set of standardized measures for gauging and publicly reporting the quality of physician care delivered in outpatient settings, the group announced Thursday.

The voluntary standards represent the consensus of more than 260 health care providers, consumer groups, professional associations, purchasers, federal agencies, and research and quality improvement organizations.

The standards could serve as tools to be used in the "pay-for-performance" movement on Capitol Hill, where lawmakers and health policy experts are eager to tie the level of provider payment to the quality of service provided.

Pay-for-performance or "P4P" means a doctor or hospital is paid more for higher scores on specific measures of performance, such as the percentage of heart attack patients who have been prescribed lifesaving beta-blocker drug therapy when they leave the hospital. Federal officials and policy wonks are touting pay-for-performance as a way to improve medical care for Medicare beneficiaries and spend federal health care dollars efficiently.

The Medicare Payment Advisory Commission (MedPAC) has urged taking about 1 percent of current federal payments to providers, such as physicians, and setting it aside for caregivers who improve the quality of their care or meet quality benchmarks.

Patients in the United States primarily receive care through outpatient services, with more than a billion visits to physician offices and hospital outpatient and emergency departments each year.

"Despite being the center of health care, there have been to this point few agreed upon quality measures specifically aimed at measuring the performance of outpatient care providers," forum officials said in a news release.

The group's board of directors approved 36 performance measures and three recommendations, all of which were vetted through the forum's formal consensus development process. The standards, the group said, represent measures of structure, process, and outcome that have been linked by evidence to quality of care for ambulatory care. Each measure also was evaluated against the forum's endorsed measure evaluation criteria of importance, scientific soundness, feasibility, and usability.

The forum is a private, not-for-profit group formed to establish consensus on health care quality performance measures and reporting.

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