Can We Measure Structured Chronic Care?

1. Can We Measure Structured Chronic Care? “Quality is now seen as a legitimate concern for purchasers, managed care plans, provider organizations, politicians and consumers and is the subject of serious measurement and reporting efforts under a variety of auspices.”Rosemary Stevens, Milbank Quarterly, 2001 “Without measurement there is no improvement; to improve, however, the measurement has to be taken consistently over time….” Don Berwick (IHI) “Measure, Learn, Improve…”Anne-Marie Audet (Commonwealth Fund, 2005) John Tooker, MD, MBA, FACP

2. StructurePatient –Centered Medical Home (PCMH) National Committee on Quality Assurance (NCQA) • Access and Communication • Patient Tracking and Registry Functions • Care Management • Patient Self-Management Support • Electronic Prescribing • Test Tracking • Performance Reporting and Improvement • Advanced Electronic Communications John Tooker, MD, MBA, FACP

3. US Performance Measurement Implement Performance Measures Develop Performance Measures Certify Performance Measures • Clinical • Complex clinical • Patient • Cost • Efficiency AQA ABMS HQA Plans CMS NCQA PCPI JCAHO NQF Multiple Public and Private Sector Stakeholders

4. Can We Measure Structured Chronic Care? “National Rating System for Docs Approved” Modern Healthcare April 2, 2008 The Patient Charter for Physician Performance Measurement, Reporting and Tiering Programs creates a national set of principles to guide measuring and reporting on physician performance, including third-party independent review of plans’ physician-performance programs.