GAO: Focus on quality, efficiency in Medicare clinical data registry program

The U.S. Department of Health & Human Services should require more evidence of improved quality and efficiency of care for Medicare patients in implementing its program for clinical data registries (CDRs), according to a report from the Government Accountability Office.

While HHS had envisioned the program evolving over time, the GAO dinged those plans as providing little specificity and substantial leeway for CDRs seeking to become qualified.

CDRs are used to track trends in both outcomes and treatments over time, and to provide feedback reports to participating physicians, benchmark physician performance vs. that of their peers and for educational activities designed to stimulate changes in clinical practice. However, from those the GAO reviewed, it was found they offer less insight on ways to improve the efficiency of care.

It should include require CDRs to focus data collection on performance measures that address the key opportunities for improvement in quality and efficiency for each CDR's target population and require them to demonstrate improvement over time on the quality and efficiency measures that they collect, the GAO said. It also should take actions that could reduce potential barriers to the development of qualified CDRs, such as concerns about complying with privacy regulations and the difficulty of funding CDRs, according to the report.

In addition, the report advised drawing on expert judgment to monitor qualified CDRs and include, if feasible, key data elements needed by qualified CDRs in its requirements under the EHR incentive programs.

The North American Spine Society and other medical specialty societies are supporting a bill in the House--the Electronic Health Record (EHR) Improvement Act--to "recognize the value of specialty clinical data registries as quality measurement and performance improvement tools in the Medicare and Medicaid EHR incentive programs."

One of the proposed changes to the 2014 physician fee schedule would integrate reporting on quality measures by for eligible professionals participating in a qualified clinical data registry.

The American College of Physicians lists the clinical quality measures reporting among the reasons Meaningful Use Stage 2 will be burdensome for physicians.

To learn more:
- find the report highlights

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