Are you seeking clarity around the purpose of the Quality section of the Quality Payment Program (QPP)? Still need some information on the essentials of the program? Recently, the Centers for Medicare & Medicaid Services (CMS) March newsletter included an elaborate breakdown on the vision of CMS Quality Strategy as well as the important connection between Quality Improvement and Quality Measurement.
CMS strives to serve the public with the goal of refining outcomes, improving experience of care and reducing the overall cost of health care through improvement. According to the newsletter published by CMS this month, CMS focuses on:
Leading quality measurement alignment, prioritization, and implementation and the development of new, innovative measures and guiding quality improvement across the nation and fostering learning networks that generate results.[i]
That being said, how does CMS intend to use mechanisms of improvement and measurement to fulfill that mission?
Quality improvement was created to concentrate on standardization, on the basis that behavior is systematic and aligned with evidence. The Plan-Do-Study-Act Cycle is a system of steps designed to promote repetition, so that behavior becomes more regular and aligned[ii]. Ultimately, trying to achieve standardized behavior through structure and process. Structure can consist of different variables like knowledge capital (the standard operating procedures you have in place), physical capital (your EHR software), human capital (different education and training), and leadership or culture.
Quality measurement is comprised of selection and choice.[iii] With a tool like quality measurement you can increase the likelihood of a positive result and outcomes, rather than an adverse result. A patient may be more inclined to choose a high performing practice because they know there is a greater chance of positive outcomes. Quality measurements give patients and clinics evidence based results – results that are reliable and valid!
These two mechanisms go hand-in-hand to implement successful and positive outcomes measures. Reach out to your fellow Doctors to discuss benchmarks and comparisons of quality measures. This will help you to reform your process and systems, to identify those best practices. Stay up-to-date with CMS tips and explanations so that you are aware of the objectives and essentials of QPP or if you would like to read more about how quality measurement and quality improvement are related to the Merit-based Incentive Payment Systems (MIPS).
[i] CMS March Newsletter. Quality Improvement and Quality Measurement. Volume 2, Edition 3. 2017.
[ii] Langley, Gerald J. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance. 2nd ed. San Francisco: Jossey-Bass, 2009. Print.
[iii]Berwick DM, James B, Coye MJ, Connections between quality measurement and improvement, Med Care, 2003;41(1 Suppl):I30-I38.n. New York: Duxbury, 2004