The magic number? AMGA wants to reduce quality measures from hundreds to 14

A compass pointing to the word "quality."
The AMGA has endorsed a set of 14 quality measures it says can save physician practices time and money. (Getty/Olivier Le Moal)

It costs physician practices in the U.S. billions of dollars and hundreds of hours each year to report quality measures. But the American Medical Group Association says that process could be simplified with the use of 14 key measures.

On Monday, AMGA endorsed the streamlined set of measures for payers, saying they would reduce the reporting burden on providers and group practices.

“Used correctly, quality measures provide an opportunity to evaluate care and drive improvements,” said Jerry Penso, M.D., AMGA’s president and CEO, in an announcement. “But providers are saddled with too many measures that are not meaningful to how they deliver care.”

The AMGA, a trade association aimed at transforming healthcare, said its members report hundreds of different quality measures to various public and private payers, but it says the vast majority are not useful in evaluating or improving quality of care. The AMGA said the cost is significant, with research indicating that on average U.S. physician practices across four common specialties annually spend more than $15.4 billion and 785 hours per physician to report quality measures.

RELATED: CMS releases 32 quality measures under consideration for 2018

AMGA’s simplified measure set would change that and emphasize value measures that are evidence-based, focused on outcomes and relevant to clinical care, Penso said. The AMGA hopes private payers and the Centers for Medicare & Medicaid Services (CMS) will adopt the standardized set of measures for use in value-based contracts. The existing quality measurement and reporting system suffers from duplicative measures and a lack of data standardization. CMS has also undertaken an effort to reduce quality measures and focus on the most critical areas for improvement, while also reducing the burden of quality reporting for all providers so they can spend more time with their patients.

Using the set of 14 core measures can save providers time and reduce costs, the AMGA said.

“By offering a standard set of measures for value-based contracts with payers, the AMGA measure set will reduce the variation in the measures that are reported and help eliminate unnecessary confusion and administrative burden. The measurement set includes both process measures, such as cancer screening and immunization rates, which focus attention on quality improvement, and outcome measures, which emphasize the need to evaluate how care is provided to best drive quality improvement,” the association said.

The set of measures was developed by a task force of AMGA members.

“In addition to selecting clinically relevant measures, we chose measures that also have demonstrated results, account for patient experience and have sufficient sample sizes to ensure statistical validity,” said Scott Hines, M.D., chief quality officer of Crystal Run Healthcare, who chaired the task force.

The measures were selected based on the collective views of integrated systems and multispecialty medical groups that are leading the move to value-based care, he said. The set is not intended to replace all other measures but rather to serve as a standardized set for reporting purposes. Organizations can still use other measures internally to drive quality improvement, he said.

The 14 measures are:

  1. Emergency department use per 1,000 patients
  2. Skilled nursing facility admissions per 1,000 patients
  3. 30-day all-cause hospital readmission
  4. Admissions for acute ambulatory sensitive conditions composite
  5. HbA1C poor control > 9%
  6. Depression screening
  7. Diabetes eye exam
  8. Hypertension/high blood pressure control
  9. CAHPS/health status/functional status
  10. Breast cancer screening
  11. Colorectal cancer screening
  12. Cervical cancer screening
  13. Pneumonia vaccination rate
  14. Pediatric well-child visits (0-15 months)