Physician Consortium for Performance Improvement: We are committed to improving quality of care

Regarding "Pay-for-performance: It's about cost control, not quality" (Column, Feb. 19): This commentary column raised important issues about performance measurement and pay-for-performance. The Executive Committee of the Physician Consortium for Performance Improvement, a consortium convened and supported by the American Medical Association, recognizes the physician's professional responsibility to provide quality health care and continues its commitment to respond to the growing public concerns about documented gaps in care and value for the health care dollar as the cost of health care services continues to rise.

The Institute of Medicine Pathways to Quality Health Care series report, "Performance Measurement: Accelerating Improvement," describes the major issues at the forefront. "On average, adults in the United States fail to receive almost half of the clinical services from which they would likely benefit. And while per capita health care spending in the United States greatly exceeds that in other industrialized countries, cross-national comparisons of health care quality reveal that other countries achieve better performance on many measures. Similarly, spending levels vary widely among U.S. regions, yet there is no evidence that more expensive regions have either better quality or improved health outcomes." The current system and efforts to address performance measurement and reporting are fragmented. "The full potential of current [quality improvement] initiatives cannot be realized without a coherent, robust, integrated performance measurement system that is purposeful, comprehensive, efficient, and transparent."

The Consortium brings the medical profession together to develop evidence-based performance measures and to promote the appropriate use of measures and measurement systems to address health care quality and patient safety issues. Currently, more than 100 organizations participate. By providing a forum for national medical specialty societies, medical boards, and other organizations committed to quality improvement, the Consortium seeks to promote physician participation in continuous quality improvement.

Pay-for-performance is only one of a number of strategies that have been suggested as having potential to improve quality. As of July 1, physicians and other eligible health care professionals will have the option to participate in the "Physician Quality Reporting Initiative" established under the Tax Relief and Health Care Act of 2006, Section 101 under Title I. It is a pay-for-reporting program at this time. Physicians who successfully report on a designated set of quality measures adopted or endorsed by a consensus organization, such as the National Quality Forum or the Ambulatory Care Quality Alliance, will be able to receive additional reimbursement up to 1.5% of total allowed charges for covered Medicare physician fee schedule services. The details of the program, including its duration, are not yet fully worked out, but it is clear that most of the measures of the designated set were developed by the Consortium.

The Consortium Executive Committee encourages the American Medical Association and all physician professional societies to educate and dialog with members about performance measurement and improvement. As efforts to positively affect quality and efficiency move forward, it is critical that physician leadership engage in the discussion about health care quality and accountability at the highest levels.

Bernard M. Rosof, MD , chair, Physician Consortium for Performance Improvement

Note: This item originally appeared at http://www.ama-assn.org/amednews/2007/03/26/edlt0326.htm.