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AARP: Retail drug prices rising faster than inflation
Retail prices for medications used most commonly by Medicare patients rose almost 10% in 2013 – more than six times faster than the rate of inflation, according to an analysis by the AARP Public Policy Institute.
In 2013, “the average annual cost of drug therapy for prescription drugs, based on the AARP combined market basket used in this study, was over $11,000 per year,” according to the report In comparison, the average Social Security benefit was $15,526, the median income for Medicare beneficiaries was $23,500 and the median U.S. household income was $52,250.
Price increases for traditional and specialty brand prescription drugs rose faster than generics, eliminating any offset the declines in generic prices might have had.
The report examined drug prices from 2006 to 2013 for a combined market basket of 622 brand name and generic versions of traditional and specialty prescription drugs.
Of the 397 drugs that were on the market for all years, the average retail price increased 81%.
Retail prices for medications used most commonly by Medicare patients rose almost 10% in 2013 – more than six times faster than the rate of inflation, according to an analysis by the AARP Public Policy Institute.
In 2013, “the average annual cost of drug therapy for prescription drugs, based on the AARP combined market basket used in this study, was over $11,000 per year,” according to the report In comparison, the average Social Security benefit was $15,526, the median income for Medicare beneficiaries was $23,500 and the median U.S. household income was $52,250.
Price increases for traditional and specialty brand prescription drugs rose faster than generics, eliminating any offset the declines in generic prices might have had.
The report examined drug prices from 2006 to 2013 for a combined market basket of 622 brand name and generic versions of traditional and specialty prescription drugs.
Of the 397 drugs that were on the market for all years, the average retail price increased 81%.
Retail prices for medications used most commonly by Medicare patients rose almost 10% in 2013 – more than six times faster than the rate of inflation, according to an analysis by the AARP Public Policy Institute.
In 2013, “the average annual cost of drug therapy for prescription drugs, based on the AARP combined market basket used in this study, was over $11,000 per year,” according to the report In comparison, the average Social Security benefit was $15,526, the median income for Medicare beneficiaries was $23,500 and the median U.S. household income was $52,250.
Price increases for traditional and specialty brand prescription drugs rose faster than generics, eliminating any offset the declines in generic prices might have had.
The report examined drug prices from 2006 to 2013 for a combined market basket of 622 brand name and generic versions of traditional and specialty prescription drugs.
Of the 397 drugs that were on the market for all years, the average retail price increased 81%.
CMS extends EHR hardship exemption deadline to July 1
Physicians and hospitals seeking a hardship exemption for not being able to meet meaningful use requirements in 2015 will have more time to file their application.
Applications for both groups are now due July 1. Previously, the deadline was March 15 for physicians and other eligible professionals and April 1 for hospitals.
The Centers for Medicare & Medicaid Services said in a statement that it is “extending the deadline so providers have sufficient time to submit their applications to avoid adjustments to their Medicare payments in 2017.”
An agency spokesman did not have any details on how many exemption requests have been made to date, nor did he say how many the agency was expecting.
Last year, Congress approved a process to allow the CMS to batch process hardship exemption requests. Before that, law required that the agency consider requests on a case by case basis.
Filing instructions for a hardship exemption can be found here.
Physicians and hospitals seeking a hardship exemption for not being able to meet meaningful use requirements in 2015 will have more time to file their application.
Applications for both groups are now due July 1. Previously, the deadline was March 15 for physicians and other eligible professionals and April 1 for hospitals.
The Centers for Medicare & Medicaid Services said in a statement that it is “extending the deadline so providers have sufficient time to submit their applications to avoid adjustments to their Medicare payments in 2017.”
An agency spokesman did not have any details on how many exemption requests have been made to date, nor did he say how many the agency was expecting.
Last year, Congress approved a process to allow the CMS to batch process hardship exemption requests. Before that, law required that the agency consider requests on a case by case basis.
Filing instructions for a hardship exemption can be found here.
Physicians and hospitals seeking a hardship exemption for not being able to meet meaningful use requirements in 2015 will have more time to file their application.
Applications for both groups are now due July 1. Previously, the deadline was March 15 for physicians and other eligible professionals and April 1 for hospitals.
The Centers for Medicare & Medicaid Services said in a statement that it is “extending the deadline so providers have sufficient time to submit their applications to avoid adjustments to their Medicare payments in 2017.”
An agency spokesman did not have any details on how many exemption requests have been made to date, nor did he say how many the agency was expecting.
Last year, Congress approved a process to allow the CMS to batch process hardship exemption requests. Before that, law required that the agency consider requests on a case by case basis.
Filing instructions for a hardship exemption can be found here.
AMA’s Stack ‘cautiously optimistic’ about MACRA implementation
WASHINGTON – Coming regulations to implement the MACRA legislation also could include sweeping reforms to meaningful use and quality reporting programs, said Dr. Steven J. Stack, president of the American Medical Association.
Dr. Stack expressed “cautious optimism” that the regulations would help doctors to return to focusing on treating patients and away from meeting the myriad of regulatory requirements that have piled up in recent years.
The AMA has been working closely with the Centers for Medicare & Medicaid Services “very candidly and very constructively” and the agency has “demonstrated a willingness to reconsider things,” Dr. Stack said at the AMA National Advocacy Conference.
The regulations to implement MACRA (the Medicare Access and CHIP Reauthorization Act of 2015) “offers CMS an uncommonly robust opportunity to take things like [the Physician Quality Reporting System], meaningful use, value-based purchasing and reconceptualize, now that we have the opportunity under one rulemaking, to say how should all of these really work together,” Dr. Stack said.
Indeed, during a keynote address at the AMA conference, CMS Administrator Andy Slavitt said one of the goals for the agency this year was to simplify things for doctors.
“We must reduce burden and give physicians back more time to spend with patients,” Mr. Slavitt said. “Several years ago, we launched an initiative that is reducing regulatory burden and saving hospitals $3.2 billion over 5 years. But we are barely scratching the surface. We have a strategic effort this year designed to reduce burden and create efficiencies in the physician’s office.”
He hinted that the MACRA regulations would be used to redefine how health IT is utilized, noting the emphasis will be on rewarding outcomes that technology helps achieve, rather than simply incentivizing the use of it; providing more flexibility to meet physician needs; leveling the playing field to allow more competition from vendors; and to address ongoing interoperability issues.
The concern Dr. Stack addressed during the press meeting was the ongoing opioid epidemic, one of the few things he expects to see legislative action on during this presidential election year.
He called for thoughtful, comprehensive solutions to addressing the problem so that it allows patients with a true medical need for chronic pain management to be able to continue to have access to needed prescription pain medications. Arbitrary prescribing caps and other fixes that, on the surface, are simple and easy to implement, should be avoided, he said.
“Those kinds of approaches for this problem could have the really undesired consequences of rather than solving the problem,” Dr. Stack said, adding that they could drive even more people from prescription pills to heroin. That “causes deaths far more rapidly than the other stuff, which takes tens of millions of Americans with legitimate chronic pain who are legitimately suffering and throwing them into horrific life problems without access to care they need.”
As an adjunct to that, Dr. Stack also addressed drug pricing, using naloxone, which is used to help patients experiencing and opioid overdose, as something that has skyrocketed in price.
In looking at 5 years of drug prices in his state of Kentucky, naloxone has gone up from just over $4.50 a pill in 2010 to $38 a pill in 2015.
“If there is one thing that I will be absolutely clear on as a physician in the United States, this is not the time for the pharmaceutical industry to play games in the midst of an epidemic that taking over a quarter-million people’s lives over the documented course of this problem,” Dr. Stack said. “This is the time for the pharmaceutical industry to do its part and make sure that naloxone is as cheap as water from a tap so that patients in need can get the care they need and have this life-saving drug. This is not a profiteering opportunity for anyone.”
WASHINGTON – Coming regulations to implement the MACRA legislation also could include sweeping reforms to meaningful use and quality reporting programs, said Dr. Steven J. Stack, president of the American Medical Association.
Dr. Stack expressed “cautious optimism” that the regulations would help doctors to return to focusing on treating patients and away from meeting the myriad of regulatory requirements that have piled up in recent years.
The AMA has been working closely with the Centers for Medicare & Medicaid Services “very candidly and very constructively” and the agency has “demonstrated a willingness to reconsider things,” Dr. Stack said at the AMA National Advocacy Conference.
The regulations to implement MACRA (the Medicare Access and CHIP Reauthorization Act of 2015) “offers CMS an uncommonly robust opportunity to take things like [the Physician Quality Reporting System], meaningful use, value-based purchasing and reconceptualize, now that we have the opportunity under one rulemaking, to say how should all of these really work together,” Dr. Stack said.
Indeed, during a keynote address at the AMA conference, CMS Administrator Andy Slavitt said one of the goals for the agency this year was to simplify things for doctors.
“We must reduce burden and give physicians back more time to spend with patients,” Mr. Slavitt said. “Several years ago, we launched an initiative that is reducing regulatory burden and saving hospitals $3.2 billion over 5 years. But we are barely scratching the surface. We have a strategic effort this year designed to reduce burden and create efficiencies in the physician’s office.”
He hinted that the MACRA regulations would be used to redefine how health IT is utilized, noting the emphasis will be on rewarding outcomes that technology helps achieve, rather than simply incentivizing the use of it; providing more flexibility to meet physician needs; leveling the playing field to allow more competition from vendors; and to address ongoing interoperability issues.
The concern Dr. Stack addressed during the press meeting was the ongoing opioid epidemic, one of the few things he expects to see legislative action on during this presidential election year.
He called for thoughtful, comprehensive solutions to addressing the problem so that it allows patients with a true medical need for chronic pain management to be able to continue to have access to needed prescription pain medications. Arbitrary prescribing caps and other fixes that, on the surface, are simple and easy to implement, should be avoided, he said.
“Those kinds of approaches for this problem could have the really undesired consequences of rather than solving the problem,” Dr. Stack said, adding that they could drive even more people from prescription pills to heroin. That “causes deaths far more rapidly than the other stuff, which takes tens of millions of Americans with legitimate chronic pain who are legitimately suffering and throwing them into horrific life problems without access to care they need.”
As an adjunct to that, Dr. Stack also addressed drug pricing, using naloxone, which is used to help patients experiencing and opioid overdose, as something that has skyrocketed in price.
In looking at 5 years of drug prices in his state of Kentucky, naloxone has gone up from just over $4.50 a pill in 2010 to $38 a pill in 2015.
“If there is one thing that I will be absolutely clear on as a physician in the United States, this is not the time for the pharmaceutical industry to play games in the midst of an epidemic that taking over a quarter-million people’s lives over the documented course of this problem,” Dr. Stack said. “This is the time for the pharmaceutical industry to do its part and make sure that naloxone is as cheap as water from a tap so that patients in need can get the care they need and have this life-saving drug. This is not a profiteering opportunity for anyone.”
WASHINGTON – Coming regulations to implement the MACRA legislation also could include sweeping reforms to meaningful use and quality reporting programs, said Dr. Steven J. Stack, president of the American Medical Association.
Dr. Stack expressed “cautious optimism” that the regulations would help doctors to return to focusing on treating patients and away from meeting the myriad of regulatory requirements that have piled up in recent years.
The AMA has been working closely with the Centers for Medicare & Medicaid Services “very candidly and very constructively” and the agency has “demonstrated a willingness to reconsider things,” Dr. Stack said at the AMA National Advocacy Conference.
The regulations to implement MACRA (the Medicare Access and CHIP Reauthorization Act of 2015) “offers CMS an uncommonly robust opportunity to take things like [the Physician Quality Reporting System], meaningful use, value-based purchasing and reconceptualize, now that we have the opportunity under one rulemaking, to say how should all of these really work together,” Dr. Stack said.
Indeed, during a keynote address at the AMA conference, CMS Administrator Andy Slavitt said one of the goals for the agency this year was to simplify things for doctors.
“We must reduce burden and give physicians back more time to spend with patients,” Mr. Slavitt said. “Several years ago, we launched an initiative that is reducing regulatory burden and saving hospitals $3.2 billion over 5 years. But we are barely scratching the surface. We have a strategic effort this year designed to reduce burden and create efficiencies in the physician’s office.”
He hinted that the MACRA regulations would be used to redefine how health IT is utilized, noting the emphasis will be on rewarding outcomes that technology helps achieve, rather than simply incentivizing the use of it; providing more flexibility to meet physician needs; leveling the playing field to allow more competition from vendors; and to address ongoing interoperability issues.
The concern Dr. Stack addressed during the press meeting was the ongoing opioid epidemic, one of the few things he expects to see legislative action on during this presidential election year.
He called for thoughtful, comprehensive solutions to addressing the problem so that it allows patients with a true medical need for chronic pain management to be able to continue to have access to needed prescription pain medications. Arbitrary prescribing caps and other fixes that, on the surface, are simple and easy to implement, should be avoided, he said.
“Those kinds of approaches for this problem could have the really undesired consequences of rather than solving the problem,” Dr. Stack said, adding that they could drive even more people from prescription pills to heroin. That “causes deaths far more rapidly than the other stuff, which takes tens of millions of Americans with legitimate chronic pain who are legitimately suffering and throwing them into horrific life problems without access to care they need.”
As an adjunct to that, Dr. Stack also addressed drug pricing, using naloxone, which is used to help patients experiencing and opioid overdose, as something that has skyrocketed in price.
In looking at 5 years of drug prices in his state of Kentucky, naloxone has gone up from just over $4.50 a pill in 2010 to $38 a pill in 2015.
“If there is one thing that I will be absolutely clear on as a physician in the United States, this is not the time for the pharmaceutical industry to play games in the midst of an epidemic that taking over a quarter-million people’s lives over the documented course of this problem,” Dr. Stack said. “This is the time for the pharmaceutical industry to do its part and make sure that naloxone is as cheap as water from a tap so that patients in need can get the care they need and have this life-saving drug. This is not a profiteering opportunity for anyone.”
AT THE AMA NATIONAL ADVOCACY CONFERENCE
Hypertension Metrics Controversial in Core Quality Measures Collaborative
Disagreement over quality measures regarding hypertension has led the American College of Cardiology and the American Heart Association to withhold their imprimatur from the Core Quality Measures Collaborative.
The collaborative ultimately chose to endorse two hypertension measures and will allow physicians to report on either. A measure put forward by the National Quality Forum defines adequate blood pressure control as less than 140/90 mm Hg while a measure from the Healthcare Effectiveness Data and Information Set (HEDIS 2016) defines adequate control as less than 150/90 mm Hg for patients over 60 years of age without diabetes or chronic kidney disease.
“AHA and ACC have concerns with the inclusion of the HEDIS 2016 measure in these core measure sets because of its likelihood to increase the number of inadequately treated patients with high [blood pressure], who would be at greater risk for heart disease and stroke,” Dr. Richard Chazal, ACC president-elect, and Dr. Mark Creager, AHA president, wrote in an editorial published Feb. 16 in Hypertension (2016 Feb 18. doi: 10.1161/HYP.0000000000000043).
The Core Quality Measures Collaborative is led by the Centers for Medicare & Medicaid Services and America’s Health Insurance Plans, with input from the National Quality Forum, medical societies, employer groups, and consumer groups, with the goal of building a uniform set of quality measures to be used by both public and private payers in value-based payment structures.
The first seven sets of measures under the collaborative were announced Feb. 16; cardiology measures were included in this limited release.
For cardiology, the quality measures span a number of areas, including chronic cardiovascular condition measures (including congestive heart failure, hypertension, ischemic heart disease/coronary heart disease, atrial fibrillation, and prevention) and acute cardiovascular condition measures (including acute myocardial infarction, angioplasty and stents, implantable cardiac defibrillators, cardiac catheterization, and pediatric heart surgery).
A number of measures were identified for future inclusion, including proportion of days covered; defect-free care for acute MI; clinician-level companion measure to hospital risk-standardized complication rate following implantation of implantable cardioverter-defibrillator; postdischarge appointment for heart failure patients; and cardiac stress imaging not meeting appropriate use criteria: routine testing after percutaneous coronary intervention.
Beyond the concerns with the hypertension measure, nothing in particular was left out of the first set of measures, Dr. Paul Casale, a member of the ACC board of trustees, said in an interview. He added that he expects to see more outcomes-related measures in the future.
“There is always the tension between current measures that we can collect more easily, which tend to be some of the more process-related measures, versus the outcomes measures, which everyone would like to see more of,” Dr. Casale said. “But we are challenged, particularly around collection, so I think moving forward we’ll look for opportunities for that.”
The set also identified a few other areas where measures are expected to be developed, including a number around heart failure, renal function measures for hypertension, and others.
According to the editorial in Hypertension, both the ACC and the AHA expect the current hypertension measures to change as new evidence is brought forward.
“AHA and ACC are currently in the process of developing a guideline for [high blood pressure] treatment that will evaluate the full span of evidence, including the endpoint of stroke,” Dr. Chazal and Dr. Creager wrote, noting that the guideline is expected to be released later this year. “Until the new guideline is published, we urge, as we did in an advisory along with the Centers for Disease Control and Prevention in 2014, all health care providers and patients to strive to reach a BP target of less than 140/90 mmHg.”
Disagreement over quality measures regarding hypertension has led the American College of Cardiology and the American Heart Association to withhold their imprimatur from the Core Quality Measures Collaborative.
The collaborative ultimately chose to endorse two hypertension measures and will allow physicians to report on either. A measure put forward by the National Quality Forum defines adequate blood pressure control as less than 140/90 mm Hg while a measure from the Healthcare Effectiveness Data and Information Set (HEDIS 2016) defines adequate control as less than 150/90 mm Hg for patients over 60 years of age without diabetes or chronic kidney disease.
“AHA and ACC have concerns with the inclusion of the HEDIS 2016 measure in these core measure sets because of its likelihood to increase the number of inadequately treated patients with high [blood pressure], who would be at greater risk for heart disease and stroke,” Dr. Richard Chazal, ACC president-elect, and Dr. Mark Creager, AHA president, wrote in an editorial published Feb. 16 in Hypertension (2016 Feb 18. doi: 10.1161/HYP.0000000000000043).
The Core Quality Measures Collaborative is led by the Centers for Medicare & Medicaid Services and America’s Health Insurance Plans, with input from the National Quality Forum, medical societies, employer groups, and consumer groups, with the goal of building a uniform set of quality measures to be used by both public and private payers in value-based payment structures.
The first seven sets of measures under the collaborative were announced Feb. 16; cardiology measures were included in this limited release.
For cardiology, the quality measures span a number of areas, including chronic cardiovascular condition measures (including congestive heart failure, hypertension, ischemic heart disease/coronary heart disease, atrial fibrillation, and prevention) and acute cardiovascular condition measures (including acute myocardial infarction, angioplasty and stents, implantable cardiac defibrillators, cardiac catheterization, and pediatric heart surgery).
A number of measures were identified for future inclusion, including proportion of days covered; defect-free care for acute MI; clinician-level companion measure to hospital risk-standardized complication rate following implantation of implantable cardioverter-defibrillator; postdischarge appointment for heart failure patients; and cardiac stress imaging not meeting appropriate use criteria: routine testing after percutaneous coronary intervention.
Beyond the concerns with the hypertension measure, nothing in particular was left out of the first set of measures, Dr. Paul Casale, a member of the ACC board of trustees, said in an interview. He added that he expects to see more outcomes-related measures in the future.
“There is always the tension between current measures that we can collect more easily, which tend to be some of the more process-related measures, versus the outcomes measures, which everyone would like to see more of,” Dr. Casale said. “But we are challenged, particularly around collection, so I think moving forward we’ll look for opportunities for that.”
The set also identified a few other areas where measures are expected to be developed, including a number around heart failure, renal function measures for hypertension, and others.
According to the editorial in Hypertension, both the ACC and the AHA expect the current hypertension measures to change as new evidence is brought forward.
“AHA and ACC are currently in the process of developing a guideline for [high blood pressure] treatment that will evaluate the full span of evidence, including the endpoint of stroke,” Dr. Chazal and Dr. Creager wrote, noting that the guideline is expected to be released later this year. “Until the new guideline is published, we urge, as we did in an advisory along with the Centers for Disease Control and Prevention in 2014, all health care providers and patients to strive to reach a BP target of less than 140/90 mmHg.”
Disagreement over quality measures regarding hypertension has led the American College of Cardiology and the American Heart Association to withhold their imprimatur from the Core Quality Measures Collaborative.
The collaborative ultimately chose to endorse two hypertension measures and will allow physicians to report on either. A measure put forward by the National Quality Forum defines adequate blood pressure control as less than 140/90 mm Hg while a measure from the Healthcare Effectiveness Data and Information Set (HEDIS 2016) defines adequate control as less than 150/90 mm Hg for patients over 60 years of age without diabetes or chronic kidney disease.
“AHA and ACC have concerns with the inclusion of the HEDIS 2016 measure in these core measure sets because of its likelihood to increase the number of inadequately treated patients with high [blood pressure], who would be at greater risk for heart disease and stroke,” Dr. Richard Chazal, ACC president-elect, and Dr. Mark Creager, AHA president, wrote in an editorial published Feb. 16 in Hypertension (2016 Feb 18. doi: 10.1161/HYP.0000000000000043).
The Core Quality Measures Collaborative is led by the Centers for Medicare & Medicaid Services and America’s Health Insurance Plans, with input from the National Quality Forum, medical societies, employer groups, and consumer groups, with the goal of building a uniform set of quality measures to be used by both public and private payers in value-based payment structures.
The first seven sets of measures under the collaborative were announced Feb. 16; cardiology measures were included in this limited release.
For cardiology, the quality measures span a number of areas, including chronic cardiovascular condition measures (including congestive heart failure, hypertension, ischemic heart disease/coronary heart disease, atrial fibrillation, and prevention) and acute cardiovascular condition measures (including acute myocardial infarction, angioplasty and stents, implantable cardiac defibrillators, cardiac catheterization, and pediatric heart surgery).
A number of measures were identified for future inclusion, including proportion of days covered; defect-free care for acute MI; clinician-level companion measure to hospital risk-standardized complication rate following implantation of implantable cardioverter-defibrillator; postdischarge appointment for heart failure patients; and cardiac stress imaging not meeting appropriate use criteria: routine testing after percutaneous coronary intervention.
Beyond the concerns with the hypertension measure, nothing in particular was left out of the first set of measures, Dr. Paul Casale, a member of the ACC board of trustees, said in an interview. He added that he expects to see more outcomes-related measures in the future.
“There is always the tension between current measures that we can collect more easily, which tend to be some of the more process-related measures, versus the outcomes measures, which everyone would like to see more of,” Dr. Casale said. “But we are challenged, particularly around collection, so I think moving forward we’ll look for opportunities for that.”
The set also identified a few other areas where measures are expected to be developed, including a number around heart failure, renal function measures for hypertension, and others.
According to the editorial in Hypertension, both the ACC and the AHA expect the current hypertension measures to change as new evidence is brought forward.
“AHA and ACC are currently in the process of developing a guideline for [high blood pressure] treatment that will evaluate the full span of evidence, including the endpoint of stroke,” Dr. Chazal and Dr. Creager wrote, noting that the guideline is expected to be released later this year. “Until the new guideline is published, we urge, as we did in an advisory along with the Centers for Disease Control and Prevention in 2014, all health care providers and patients to strive to reach a BP target of less than 140/90 mmHg.”
Hypertension metrics controversial in Core Quality Measures Collaborative
Disagreement over quality measures regarding hypertension has led the American College of Cardiology and the American Heart Association to withhold their imprimatur from the Core Quality Measures Collaborative.
The collaborative ultimately chose to endorse two hypertension measures and will allow physicians to report on either. A measure put forward by the National Quality Forum defines adequate blood pressure control as less than 140/90 mm Hg while a measure from the Healthcare Effectiveness Data and Information Set (HEDIS 2016) defines adequate control as less than 150/90 mm Hg for patients over 60 years of age without diabetes or chronic kidney disease.
“AHA and ACC have concerns with the inclusion of the HEDIS 2016 measure in these core measure sets because of its likelihood to increase the number of inadequately treated patients with high [blood pressure], who would be at greater risk for heart disease and stroke,” Dr. Richard Chazal, ACC president-elect, and Dr. Mark Creager, AHA president, wrote in an editorial published Feb. 16 in Hypertension (2016 Feb 18. doi: 10.1161/HYP.0000000000000043).
The Core Quality Measures Collaborative is led by the Centers for Medicare & Medicaid Services and America’s Health Insurance Plans, with input from the National Quality Forum, medical societies, employer groups, and consumer groups, with the goal of building a uniform set of quality measures to be used by both public and private payers in value-based payment structures.
The first seven sets of measures under the collaborative were announced Feb. 16; cardiology measures were included in this limited release.
For cardiology, the quality measures span a number of areas, including chronic cardiovascular condition measures (including congestive heart failure, hypertension, ischemic heart disease/coronary heart disease, atrial fibrillation, and prevention) and acute cardiovascular condition measures (including acute myocardial infarction, angioplasty and stents, implantable cardiac defibrillators, cardiac catheterization, and pediatric heart surgery).
A number of measures were identified for future inclusion, including proportion of days covered; defect-free care for acute MI; clinician-level companion measure to hospital risk-standardized complication rate following implantation of implantable cardioverter-defibrillator; postdischarge appointment for heart failure patients; and cardiac stress imaging not meeting appropriate use criteria: routine testing after percutaneous coronary intervention.
Beyond the concerns with the hypertension measure, nothing in particular was left out of the first set of measures, Dr. Paul Casale, a member of the ACC board of trustees, said in an interview. He added that he expects to see more outcomes-related measures in the future.
“There is always the tension between current measures that we can collect more easily, which tend to be some of the more process-related measures, versus the outcomes measures, which everyone would like to see more of,” Dr. Casale said. “But we are challenged, particularly around collection, so I think moving forward we’ll look for opportunities for that.”
The set also identified a few other areas where measures are expected to be developed, including a number around heart failure, renal function measures for hypertension, and others.
According to the editorial in Hypertension, both the ACC and the AHA expect the current hypertension measures to change as new evidence is brought forward.
“AHA and ACC are currently in the process of developing a guideline for [high blood pressure] treatment that will evaluate the full span of evidence, including the endpoint of stroke,” Dr. Chazal and Dr. Creager wrote, noting that the guideline is expected to be released later this year. “Until the new guideline is published, we urge, as we did in an advisory along with the Centers for Disease Control and Prevention in 2014, all health care providers and patients to strive to reach a BP target of less than 140/90 mmHg.”
Disagreement over quality measures regarding hypertension has led the American College of Cardiology and the American Heart Association to withhold their imprimatur from the Core Quality Measures Collaborative.
The collaborative ultimately chose to endorse two hypertension measures and will allow physicians to report on either. A measure put forward by the National Quality Forum defines adequate blood pressure control as less than 140/90 mm Hg while a measure from the Healthcare Effectiveness Data and Information Set (HEDIS 2016) defines adequate control as less than 150/90 mm Hg for patients over 60 years of age without diabetes or chronic kidney disease.
“AHA and ACC have concerns with the inclusion of the HEDIS 2016 measure in these core measure sets because of its likelihood to increase the number of inadequately treated patients with high [blood pressure], who would be at greater risk for heart disease and stroke,” Dr. Richard Chazal, ACC president-elect, and Dr. Mark Creager, AHA president, wrote in an editorial published Feb. 16 in Hypertension (2016 Feb 18. doi: 10.1161/HYP.0000000000000043).
The Core Quality Measures Collaborative is led by the Centers for Medicare & Medicaid Services and America’s Health Insurance Plans, with input from the National Quality Forum, medical societies, employer groups, and consumer groups, with the goal of building a uniform set of quality measures to be used by both public and private payers in value-based payment structures.
The first seven sets of measures under the collaborative were announced Feb. 16; cardiology measures were included in this limited release.
For cardiology, the quality measures span a number of areas, including chronic cardiovascular condition measures (including congestive heart failure, hypertension, ischemic heart disease/coronary heart disease, atrial fibrillation, and prevention) and acute cardiovascular condition measures (including acute myocardial infarction, angioplasty and stents, implantable cardiac defibrillators, cardiac catheterization, and pediatric heart surgery).
A number of measures were identified for future inclusion, including proportion of days covered; defect-free care for acute MI; clinician-level companion measure to hospital risk-standardized complication rate following implantation of implantable cardioverter-defibrillator; postdischarge appointment for heart failure patients; and cardiac stress imaging not meeting appropriate use criteria: routine testing after percutaneous coronary intervention.
Beyond the concerns with the hypertension measure, nothing in particular was left out of the first set of measures, Dr. Paul Casale, a member of the ACC board of trustees, said in an interview. He added that he expects to see more outcomes-related measures in the future.
“There is always the tension between current measures that we can collect more easily, which tend to be some of the more process-related measures, versus the outcomes measures, which everyone would like to see more of,” Dr. Casale said. “But we are challenged, particularly around collection, so I think moving forward we’ll look for opportunities for that.”
The set also identified a few other areas where measures are expected to be developed, including a number around heart failure, renal function measures for hypertension, and others.
According to the editorial in Hypertension, both the ACC and the AHA expect the current hypertension measures to change as new evidence is brought forward.
“AHA and ACC are currently in the process of developing a guideline for [high blood pressure] treatment that will evaluate the full span of evidence, including the endpoint of stroke,” Dr. Chazal and Dr. Creager wrote, noting that the guideline is expected to be released later this year. “Until the new guideline is published, we urge, as we did in an advisory along with the Centers for Disease Control and Prevention in 2014, all health care providers and patients to strive to reach a BP target of less than 140/90 mmHg.”
Disagreement over quality measures regarding hypertension has led the American College of Cardiology and the American Heart Association to withhold their imprimatur from the Core Quality Measures Collaborative.
The collaborative ultimately chose to endorse two hypertension measures and will allow physicians to report on either. A measure put forward by the National Quality Forum defines adequate blood pressure control as less than 140/90 mm Hg while a measure from the Healthcare Effectiveness Data and Information Set (HEDIS 2016) defines adequate control as less than 150/90 mm Hg for patients over 60 years of age without diabetes or chronic kidney disease.
“AHA and ACC have concerns with the inclusion of the HEDIS 2016 measure in these core measure sets because of its likelihood to increase the number of inadequately treated patients with high [blood pressure], who would be at greater risk for heart disease and stroke,” Dr. Richard Chazal, ACC president-elect, and Dr. Mark Creager, AHA president, wrote in an editorial published Feb. 16 in Hypertension (2016 Feb 18. doi: 10.1161/HYP.0000000000000043).
The Core Quality Measures Collaborative is led by the Centers for Medicare & Medicaid Services and America’s Health Insurance Plans, with input from the National Quality Forum, medical societies, employer groups, and consumer groups, with the goal of building a uniform set of quality measures to be used by both public and private payers in value-based payment structures.
The first seven sets of measures under the collaborative were announced Feb. 16; cardiology measures were included in this limited release.
For cardiology, the quality measures span a number of areas, including chronic cardiovascular condition measures (including congestive heart failure, hypertension, ischemic heart disease/coronary heart disease, atrial fibrillation, and prevention) and acute cardiovascular condition measures (including acute myocardial infarction, angioplasty and stents, implantable cardiac defibrillators, cardiac catheterization, and pediatric heart surgery).
A number of measures were identified for future inclusion, including proportion of days covered; defect-free care for acute MI; clinician-level companion measure to hospital risk-standardized complication rate following implantation of implantable cardioverter-defibrillator; postdischarge appointment for heart failure patients; and cardiac stress imaging not meeting appropriate use criteria: routine testing after percutaneous coronary intervention.
Beyond the concerns with the hypertension measure, nothing in particular was left out of the first set of measures, Dr. Paul Casale, a member of the ACC board of trustees, said in an interview. He added that he expects to see more outcomes-related measures in the future.
“There is always the tension between current measures that we can collect more easily, which tend to be some of the more process-related measures, versus the outcomes measures, which everyone would like to see more of,” Dr. Casale said. “But we are challenged, particularly around collection, so I think moving forward we’ll look for opportunities for that.”
The set also identified a few other areas where measures are expected to be developed, including a number around heart failure, renal function measures for hypertension, and others.
According to the editorial in Hypertension, both the ACC and the AHA expect the current hypertension measures to change as new evidence is brought forward.
“AHA and ACC are currently in the process of developing a guideline for [high blood pressure] treatment that will evaluate the full span of evidence, including the endpoint of stroke,” Dr. Chazal and Dr. Creager wrote, noting that the guideline is expected to be released later this year. “Until the new guideline is published, we urge, as we did in an advisory along with the Centers for Disease Control and Prevention in 2014, all health care providers and patients to strive to reach a BP target of less than 140/90 mmHg.”
AGA survey finds more patient education needed about OTC pain meds
With patients indicating that they are regularly ignoring dosing guidelines on over-the-counter pain medications, the American Gastroenterological Association is calling for better patient education, including a more active role for doctors.
In particular, AGA is asking doctors to be more proactive in understanding how their patients are using over-the-counter pain medications after a survey revealed that 43% of respondents who suffer from chronic pain said that they knowingly have taken more than the recommended dose, with 28% saying they have experienced complications due to OTC pain medication overdose.
“Patients are self-medicating and actually ignoring the dosing guidelines,” Dr. Charles Melbern Wilcox, professor at the University of Alabama at Birmingham, said during a Jan. 25 teleconference to talk about the survey results. “Commonly, patients are unaware of overdose symptoms or not connecting their symptoms to over-the-counter pain medicine overdose or overusage. Patients are presenting with nausea, abdominal pain, and stomach ulcers due to over-the-counter pain medicine overdose and overuse. Patients with chronic pain are often taking multiple medications.”
AGA hosted the conference call as part of the “Gut Check: Know Your Medicine” campaign to encourage educating consumers on the proper usage and risks associated with OTC pain medication. The survey of 1,015 adults aged 30 years or older (479 were currently experiencing chronic pain at the time of the survey) and 251 licensed gastroenterologists conducted as part of the campaign occurred in September and October 2015.
Additionally, chronic pain sufferers also are taking multisymptom OTC products for allergy, cold, and flu symptoms that could cause the extra intake of pain medication.
“Our survey findings suggest that providers give more attention to patients with chronic pain since they are likely to take more than the recommended dose and also to take more than one pain medicine,” Dr. Byron Cryer, assistant dean for faculty diversity and development at the University of Texas Southwestern Medical Center, Dallas, said during the call to discuss the survey results and AGA campaign to promote OTC pain medication awareness. “Providers should work with patients to determine the best treatment options that address the patient’s pain while using medicines safely.”
Dr. Cryer noted that health care professionals “must start asking simple direct questions about pain medicine use each time they see a patient and must lead the way to improve the lines of communication.”
He added that having these active conversations about pain medications, both OTC and prescribed, can provide the necessary warnings about the products that “are likely to be remembered by patients” and will allow doctors to provide follow-up timing and instructions if the pain does not subside in a certain amount of time.
Another survey finding that is adding to the call for more patient education is that, according to the survey’s executive summary, most chronic pain sufferers “say they don’t always read the full Drug Facts label on an OTC pain medicine they haven’t taken before (66%) and many say the directions on the labels of OTC pain medicines are really just guidelines – they know what works for them (43%).”
Additionally, the survey found that 27% of chronic pain sufferers “are willing to take more of an OTC pain medicine than directed because they incorrectly believe their symptoms will disappear faster.”
With patients indicating that they are regularly ignoring dosing guidelines on over-the-counter pain medications, the American Gastroenterological Association is calling for better patient education, including a more active role for doctors.
In particular, AGA is asking doctors to be more proactive in understanding how their patients are using over-the-counter pain medications after a survey revealed that 43% of respondents who suffer from chronic pain said that they knowingly have taken more than the recommended dose, with 28% saying they have experienced complications due to OTC pain medication overdose.
“Patients are self-medicating and actually ignoring the dosing guidelines,” Dr. Charles Melbern Wilcox, professor at the University of Alabama at Birmingham, said during a Jan. 25 teleconference to talk about the survey results. “Commonly, patients are unaware of overdose symptoms or not connecting their symptoms to over-the-counter pain medicine overdose or overusage. Patients are presenting with nausea, abdominal pain, and stomach ulcers due to over-the-counter pain medicine overdose and overuse. Patients with chronic pain are often taking multiple medications.”
AGA hosted the conference call as part of the “Gut Check: Know Your Medicine” campaign to encourage educating consumers on the proper usage and risks associated with OTC pain medication. The survey of 1,015 adults aged 30 years or older (479 were currently experiencing chronic pain at the time of the survey) and 251 licensed gastroenterologists conducted as part of the campaign occurred in September and October 2015.
Additionally, chronic pain sufferers also are taking multisymptom OTC products for allergy, cold, and flu symptoms that could cause the extra intake of pain medication.
“Our survey findings suggest that providers give more attention to patients with chronic pain since they are likely to take more than the recommended dose and also to take more than one pain medicine,” Dr. Byron Cryer, assistant dean for faculty diversity and development at the University of Texas Southwestern Medical Center, Dallas, said during the call to discuss the survey results and AGA campaign to promote OTC pain medication awareness. “Providers should work with patients to determine the best treatment options that address the patient’s pain while using medicines safely.”
Dr. Cryer noted that health care professionals “must start asking simple direct questions about pain medicine use each time they see a patient and must lead the way to improve the lines of communication.”
He added that having these active conversations about pain medications, both OTC and prescribed, can provide the necessary warnings about the products that “are likely to be remembered by patients” and will allow doctors to provide follow-up timing and instructions if the pain does not subside in a certain amount of time.
Another survey finding that is adding to the call for more patient education is that, according to the survey’s executive summary, most chronic pain sufferers “say they don’t always read the full Drug Facts label on an OTC pain medicine they haven’t taken before (66%) and many say the directions on the labels of OTC pain medicines are really just guidelines – they know what works for them (43%).”
Additionally, the survey found that 27% of chronic pain sufferers “are willing to take more of an OTC pain medicine than directed because they incorrectly believe their symptoms will disappear faster.”
With patients indicating that they are regularly ignoring dosing guidelines on over-the-counter pain medications, the American Gastroenterological Association is calling for better patient education, including a more active role for doctors.
In particular, AGA is asking doctors to be more proactive in understanding how their patients are using over-the-counter pain medications after a survey revealed that 43% of respondents who suffer from chronic pain said that they knowingly have taken more than the recommended dose, with 28% saying they have experienced complications due to OTC pain medication overdose.
“Patients are self-medicating and actually ignoring the dosing guidelines,” Dr. Charles Melbern Wilcox, professor at the University of Alabama at Birmingham, said during a Jan. 25 teleconference to talk about the survey results. “Commonly, patients are unaware of overdose symptoms or not connecting their symptoms to over-the-counter pain medicine overdose or overusage. Patients are presenting with nausea, abdominal pain, and stomach ulcers due to over-the-counter pain medicine overdose and overuse. Patients with chronic pain are often taking multiple medications.”
AGA hosted the conference call as part of the “Gut Check: Know Your Medicine” campaign to encourage educating consumers on the proper usage and risks associated with OTC pain medication. The survey of 1,015 adults aged 30 years or older (479 were currently experiencing chronic pain at the time of the survey) and 251 licensed gastroenterologists conducted as part of the campaign occurred in September and October 2015.
Additionally, chronic pain sufferers also are taking multisymptom OTC products for allergy, cold, and flu symptoms that could cause the extra intake of pain medication.
“Our survey findings suggest that providers give more attention to patients with chronic pain since they are likely to take more than the recommended dose and also to take more than one pain medicine,” Dr. Byron Cryer, assistant dean for faculty diversity and development at the University of Texas Southwestern Medical Center, Dallas, said during the call to discuss the survey results and AGA campaign to promote OTC pain medication awareness. “Providers should work with patients to determine the best treatment options that address the patient’s pain while using medicines safely.”
Dr. Cryer noted that health care professionals “must start asking simple direct questions about pain medicine use each time they see a patient and must lead the way to improve the lines of communication.”
He added that having these active conversations about pain medications, both OTC and prescribed, can provide the necessary warnings about the products that “are likely to be remembered by patients” and will allow doctors to provide follow-up timing and instructions if the pain does not subside in a certain amount of time.
Another survey finding that is adding to the call for more patient education is that, according to the survey’s executive summary, most chronic pain sufferers “say they don’t always read the full Drug Facts label on an OTC pain medicine they haven’t taken before (66%) and many say the directions on the labels of OTC pain medicines are really just guidelines – they know what works for them (43%).”
Additionally, the survey found that 27% of chronic pain sufferers “are willing to take more of an OTC pain medicine than directed because they incorrectly believe their symptoms will disappear faster.”
ACOG pushes for contraception measures in Core Quality Measures Collaborative
Disagreement over quality measures regarding contraception has led the American College of Obstetricians and Gynecologists to withhold its imprimatur from the Core Quality Measures Collaborative.
“Although ACOG representatives did participate in the process to select measures to be included in the Core Quality Measures Collaborative process, ACOG did not choose to be recognized for participation until further agreement can be made regarding quality measures related to effective contraceptives and immediate postpartum contraception,” Dr. Barbara Levy, ACOG vice president of health policy, said in an interview. “ACOG believes that measures can help create accountability among health systems regarding contraceptive access, providing an opportunity to prevent unintended pregnancies.”
The Core Quality Measures Collaborative is lead by the Centers for Medicare & Medicaid Services and America’s Health Insurance Plans, with input from the National Quality Forum, medical societies, employer groups, and consumer groups, with the goal of building a uniform set of quality measures to be used by both public and private payers in value-based payment structures.
The first seven sets of measures under the collaborative were announced Feb. 16; ob.gyn. measures were included in this limited release.
For ob.gyn., the measures are blocked into two sets. Metrics in the ambulatory care setting look at frequency of ongoing prenatal care, cervical and breast cancer screening, chlamydia screening and follow-up, and appropriate work-up prior to endometrial ablation. Measures in the hospital/acute care setting include incidence of episiotomy, elective delivery, cesarean sections, antenatal steroids, and exclusive breastfeeding.
Four areas identified for future development include physician-level urinary incontinence screening, more on cesarean sections, Tdap/influenza administration in pregnancy, and HIV screening of STI patients.
ACOG said it will continue to push for the inclusion of contraception measures as part of the measures, particularly as access to them continues to be an issue.
“Although the Affordable Care Act requires insurance plans to cover the full range of Food and Drug Administration–approved contraceptive methods, we know that implementation of this provision has not been universal, and some women’s needs are currently unmet,” Dr. Levy said. “Because of this, ACOG continues to advocate for quality measures that will lead to meaningful improvements in access to effective contraception and immediate postpartum contraception. It is our hope that we can advance the commitment of commercial health insurance plans to promoting the most effective contraceptive methods in a way that meets the needs of more American women.”
Disagreement over quality measures regarding contraception has led the American College of Obstetricians and Gynecologists to withhold its imprimatur from the Core Quality Measures Collaborative.
“Although ACOG representatives did participate in the process to select measures to be included in the Core Quality Measures Collaborative process, ACOG did not choose to be recognized for participation until further agreement can be made regarding quality measures related to effective contraceptives and immediate postpartum contraception,” Dr. Barbara Levy, ACOG vice president of health policy, said in an interview. “ACOG believes that measures can help create accountability among health systems regarding contraceptive access, providing an opportunity to prevent unintended pregnancies.”
The Core Quality Measures Collaborative is lead by the Centers for Medicare & Medicaid Services and America’s Health Insurance Plans, with input from the National Quality Forum, medical societies, employer groups, and consumer groups, with the goal of building a uniform set of quality measures to be used by both public and private payers in value-based payment structures.
The first seven sets of measures under the collaborative were announced Feb. 16; ob.gyn. measures were included in this limited release.
For ob.gyn., the measures are blocked into two sets. Metrics in the ambulatory care setting look at frequency of ongoing prenatal care, cervical and breast cancer screening, chlamydia screening and follow-up, and appropriate work-up prior to endometrial ablation. Measures in the hospital/acute care setting include incidence of episiotomy, elective delivery, cesarean sections, antenatal steroids, and exclusive breastfeeding.
Four areas identified for future development include physician-level urinary incontinence screening, more on cesarean sections, Tdap/influenza administration in pregnancy, and HIV screening of STI patients.
ACOG said it will continue to push for the inclusion of contraception measures as part of the measures, particularly as access to them continues to be an issue.
“Although the Affordable Care Act requires insurance plans to cover the full range of Food and Drug Administration–approved contraceptive methods, we know that implementation of this provision has not been universal, and some women’s needs are currently unmet,” Dr. Levy said. “Because of this, ACOG continues to advocate for quality measures that will lead to meaningful improvements in access to effective contraception and immediate postpartum contraception. It is our hope that we can advance the commitment of commercial health insurance plans to promoting the most effective contraceptive methods in a way that meets the needs of more American women.”
Disagreement over quality measures regarding contraception has led the American College of Obstetricians and Gynecologists to withhold its imprimatur from the Core Quality Measures Collaborative.
“Although ACOG representatives did participate in the process to select measures to be included in the Core Quality Measures Collaborative process, ACOG did not choose to be recognized for participation until further agreement can be made regarding quality measures related to effective contraceptives and immediate postpartum contraception,” Dr. Barbara Levy, ACOG vice president of health policy, said in an interview. “ACOG believes that measures can help create accountability among health systems regarding contraceptive access, providing an opportunity to prevent unintended pregnancies.”
The Core Quality Measures Collaborative is lead by the Centers for Medicare & Medicaid Services and America’s Health Insurance Plans, with input from the National Quality Forum, medical societies, employer groups, and consumer groups, with the goal of building a uniform set of quality measures to be used by both public and private payers in value-based payment structures.
The first seven sets of measures under the collaborative were announced Feb. 16; ob.gyn. measures were included in this limited release.
For ob.gyn., the measures are blocked into two sets. Metrics in the ambulatory care setting look at frequency of ongoing prenatal care, cervical and breast cancer screening, chlamydia screening and follow-up, and appropriate work-up prior to endometrial ablation. Measures in the hospital/acute care setting include incidence of episiotomy, elective delivery, cesarean sections, antenatal steroids, and exclusive breastfeeding.
Four areas identified for future development include physician-level urinary incontinence screening, more on cesarean sections, Tdap/influenza administration in pregnancy, and HIV screening of STI patients.
ACOG said it will continue to push for the inclusion of contraception measures as part of the measures, particularly as access to them continues to be an issue.
“Although the Affordable Care Act requires insurance plans to cover the full range of Food and Drug Administration–approved contraceptive methods, we know that implementation of this provision has not been universal, and some women’s needs are currently unmet,” Dr. Levy said. “Because of this, ACOG continues to advocate for quality measures that will lead to meaningful improvements in access to effective contraception and immediate postpartum contraception. It is our hope that we can advance the commitment of commercial health insurance plans to promoting the most effective contraceptive methods in a way that meets the needs of more American women.”
Doctors, payers collaborate to simplify and align quality measures
The Centers for Medicare & Medicaid Services and America’s Health Insurance Plans on Feb 16 announced a set of core quality measures across seven areas that will serve as the foundation for a more uniform set of quality metrics that will be used by both public and private payers.
The CMS and AHIP are working with the National Quality Forum, medical specialty societies, employer groups, and consumer groups under an umbrella organization called the Core Quality Measures Collaborative. Together, they derived a set of measures that are “meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost,” the CMS noted in a fact sheet.
Involved medical specialty societies include the American Academy of Family Physicians, American College of Cardiology, American Heart Association, American College of Physicians, American Gastroenterological Association, HIV Medicine Association, Infectious Diseases Society of America, American Academy of Pediatrics, American Society of Clinical Oncology, and the American Medical Association.
The collaborative announced core measures in seven areas: accountable care organizations/patient centered medical homes/primary care, cardiology, gastroenterology, HIV and hepatitis C, medical oncology, obstetrics and gynecology, and orthopedics. Measures in additional areas will be released in the future and the core sets will be reviewed and updated on a regular basis.
“I think [this collaboration] strikes the best balance between what is feasible and what is desirable,” Dr. Ziad Gellad, chair of the AGA Quality Measures Committee, said in an interview.
For Medicare, Medicaid, and other public programs, the measure sets will be implemented and updated through the physician fee schedule in the coming Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs). Private payers are expected to begin implementing these quality measures as physician contracts come up for renewal.
“I think one of the biggest challenges will be how to collect these measures, because the decision about what measures to include was only driven in part by the feasibility,” Dr. Gellad said. “A large part was driven by what are the best metrics and what are most important outcomes and processes to evaluate. I think in terms of feasibility, that is going to be the next important question. How do you improve the feasibility of these measurements in practice?”
Electronic health records will play an integral part, as a FAQ released by AHIP notes that several of the measures “require that clinical data be extracted from EHRs or registries or be self-reported by clinicians.” It adds that clinicians and payers “will need to work together to create a reporting infrastructure for such measures” in areas where it is currently lacking.
HIV/Hep C measures get thumbs up
The Infectious Disease Society of America is on-board with the first set of quality metrics around HIV and hepatitis C released by the Core Quality Measures Collaborative, but it will be looking for more diseases and conditions in the future.
Consensus from the collaborative includes measures in HIV related to pneumocystis jiroveci pneumonia prophylaxis, sexually transmitted disease screening, HIV viral load suppression, HIV medical visit frequency, annual cervical cancer screening, and HIV screening of STI patients.
For hepatitis C, measures include screening for hepatocellular carcinoma in patients with hepatitis C cirrhosis and one-time screening for patients at risk for HCV.
With regard to these measure sets, “We don’t think there is anything missing,” Andres Rodriguez, director for practice & policy at the Infectious Diseases Society of America, said in an interview. “Certainly there is more to be done in the realm of infectious diseases and the issue there is, and we are working this, is involving more quality measures for infectious diseases and conditions. As they get incorporated into quality programs on the CMS side, we would then hope to have them transfer over to the commercial side.”
Current plans at the moment only address future HIV/hepatitis C measures.
GI quality measures target endoscopy, IBD, and hep C
The first set of quality measures related to gastroenterology focus on three areas: inflammatory bowel disease, endoscopy and polyp surveillance, and hepatitis C.
In the inflammatory bowel disease measure set, consensus was reached on two measures: dealing with preventive care (corticosteroid-related iatrogenic injury – bone loss assessment) and an assessment of hepatitis B status before initiating anti–tumor necrosis factor therapy.
The five measures in the endoscopy and polyp surveillance set all relate to colonoscopy: appropriate follow-up interval for normal colonoscopy in average-risk patients; colonoscopy interval for patients with a history of adenomatous polyps; avoidance of inappropriate use; screening colonoscopy adenoma detection rate measure; and age-appropriate screening colonoscopy.
Two measures in the hepatitis C measure set include screening for hepatocellular carcinoma in patients with hepatitis C cirrhosis and one-time screening for hepatitis C virus for patients at risk.
Future areas for consideration of measure development include chronic liver disease, colorectal cancer screening, adverse events related to colonoscopy, assessing the quality of colonoscopy, gastroesophageal reflux disease and cirrhosis measures, and Barrett’s esophagus.
“I think it is an appropriate set of metrics for gastroenterology and hepatology,” said Dr. Gellad. “It was a collaborative approach. We had influence over the measures that were chosen for our specialty, but not the final say.”
The Centers for Medicare & Medicaid Services and America’s Health Insurance Plans on Feb 16 announced a set of core quality measures across seven areas that will serve as the foundation for a more uniform set of quality metrics that will be used by both public and private payers.
The CMS and AHIP are working with the National Quality Forum, medical specialty societies, employer groups, and consumer groups under an umbrella organization called the Core Quality Measures Collaborative. Together, they derived a set of measures that are “meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost,” the CMS noted in a fact sheet.
Involved medical specialty societies include the American Academy of Family Physicians, American College of Cardiology, American Heart Association, American College of Physicians, American Gastroenterological Association, HIV Medicine Association, Infectious Diseases Society of America, American Academy of Pediatrics, American Society of Clinical Oncology, and the American Medical Association.
The collaborative announced core measures in seven areas: accountable care organizations/patient centered medical homes/primary care, cardiology, gastroenterology, HIV and hepatitis C, medical oncology, obstetrics and gynecology, and orthopedics. Measures in additional areas will be released in the future and the core sets will be reviewed and updated on a regular basis.
“I think [this collaboration] strikes the best balance between what is feasible and what is desirable,” Dr. Ziad Gellad, chair of the AGA Quality Measures Committee, said in an interview.
For Medicare, Medicaid, and other public programs, the measure sets will be implemented and updated through the physician fee schedule in the coming Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs). Private payers are expected to begin implementing these quality measures as physician contracts come up for renewal.
“I think one of the biggest challenges will be how to collect these measures, because the decision about what measures to include was only driven in part by the feasibility,” Dr. Gellad said. “A large part was driven by what are the best metrics and what are most important outcomes and processes to evaluate. I think in terms of feasibility, that is going to be the next important question. How do you improve the feasibility of these measurements in practice?”
Electronic health records will play an integral part, as a FAQ released by AHIP notes that several of the measures “require that clinical data be extracted from EHRs or registries or be self-reported by clinicians.” It adds that clinicians and payers “will need to work together to create a reporting infrastructure for such measures” in areas where it is currently lacking.
HIV/Hep C measures get thumbs up
The Infectious Disease Society of America is on-board with the first set of quality metrics around HIV and hepatitis C released by the Core Quality Measures Collaborative, but it will be looking for more diseases and conditions in the future.
Consensus from the collaborative includes measures in HIV related to pneumocystis jiroveci pneumonia prophylaxis, sexually transmitted disease screening, HIV viral load suppression, HIV medical visit frequency, annual cervical cancer screening, and HIV screening of STI patients.
For hepatitis C, measures include screening for hepatocellular carcinoma in patients with hepatitis C cirrhosis and one-time screening for patients at risk for HCV.
With regard to these measure sets, “We don’t think there is anything missing,” Andres Rodriguez, director for practice & policy at the Infectious Diseases Society of America, said in an interview. “Certainly there is more to be done in the realm of infectious diseases and the issue there is, and we are working this, is involving more quality measures for infectious diseases and conditions. As they get incorporated into quality programs on the CMS side, we would then hope to have them transfer over to the commercial side.”
Current plans at the moment only address future HIV/hepatitis C measures.
GI quality measures target endoscopy, IBD, and hep C
The first set of quality measures related to gastroenterology focus on three areas: inflammatory bowel disease, endoscopy and polyp surveillance, and hepatitis C.
In the inflammatory bowel disease measure set, consensus was reached on two measures: dealing with preventive care (corticosteroid-related iatrogenic injury – bone loss assessment) and an assessment of hepatitis B status before initiating anti–tumor necrosis factor therapy.
The five measures in the endoscopy and polyp surveillance set all relate to colonoscopy: appropriate follow-up interval for normal colonoscopy in average-risk patients; colonoscopy interval for patients with a history of adenomatous polyps; avoidance of inappropriate use; screening colonoscopy adenoma detection rate measure; and age-appropriate screening colonoscopy.
Two measures in the hepatitis C measure set include screening for hepatocellular carcinoma in patients with hepatitis C cirrhosis and one-time screening for hepatitis C virus for patients at risk.
Future areas for consideration of measure development include chronic liver disease, colorectal cancer screening, adverse events related to colonoscopy, assessing the quality of colonoscopy, gastroesophageal reflux disease and cirrhosis measures, and Barrett’s esophagus.
“I think it is an appropriate set of metrics for gastroenterology and hepatology,” said Dr. Gellad. “It was a collaborative approach. We had influence over the measures that were chosen for our specialty, but not the final say.”
The Centers for Medicare & Medicaid Services and America’s Health Insurance Plans on Feb 16 announced a set of core quality measures across seven areas that will serve as the foundation for a more uniform set of quality metrics that will be used by both public and private payers.
The CMS and AHIP are working with the National Quality Forum, medical specialty societies, employer groups, and consumer groups under an umbrella organization called the Core Quality Measures Collaborative. Together, they derived a set of measures that are “meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost,” the CMS noted in a fact sheet.
Involved medical specialty societies include the American Academy of Family Physicians, American College of Cardiology, American Heart Association, American College of Physicians, American Gastroenterological Association, HIV Medicine Association, Infectious Diseases Society of America, American Academy of Pediatrics, American Society of Clinical Oncology, and the American Medical Association.
The collaborative announced core measures in seven areas: accountable care organizations/patient centered medical homes/primary care, cardiology, gastroenterology, HIV and hepatitis C, medical oncology, obstetrics and gynecology, and orthopedics. Measures in additional areas will be released in the future and the core sets will be reviewed and updated on a regular basis.
“I think [this collaboration] strikes the best balance between what is feasible and what is desirable,” Dr. Ziad Gellad, chair of the AGA Quality Measures Committee, said in an interview.
For Medicare, Medicaid, and other public programs, the measure sets will be implemented and updated through the physician fee schedule in the coming Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs). Private payers are expected to begin implementing these quality measures as physician contracts come up for renewal.
“I think one of the biggest challenges will be how to collect these measures, because the decision about what measures to include was only driven in part by the feasibility,” Dr. Gellad said. “A large part was driven by what are the best metrics and what are most important outcomes and processes to evaluate. I think in terms of feasibility, that is going to be the next important question. How do you improve the feasibility of these measurements in practice?”
Electronic health records will play an integral part, as a FAQ released by AHIP notes that several of the measures “require that clinical data be extracted from EHRs or registries or be self-reported by clinicians.” It adds that clinicians and payers “will need to work together to create a reporting infrastructure for such measures” in areas where it is currently lacking.
HIV/Hep C measures get thumbs up
The Infectious Disease Society of America is on-board with the first set of quality metrics around HIV and hepatitis C released by the Core Quality Measures Collaborative, but it will be looking for more diseases and conditions in the future.
Consensus from the collaborative includes measures in HIV related to pneumocystis jiroveci pneumonia prophylaxis, sexually transmitted disease screening, HIV viral load suppression, HIV medical visit frequency, annual cervical cancer screening, and HIV screening of STI patients.
For hepatitis C, measures include screening for hepatocellular carcinoma in patients with hepatitis C cirrhosis and one-time screening for patients at risk for HCV.
With regard to these measure sets, “We don’t think there is anything missing,” Andres Rodriguez, director for practice & policy at the Infectious Diseases Society of America, said in an interview. “Certainly there is more to be done in the realm of infectious diseases and the issue there is, and we are working this, is involving more quality measures for infectious diseases and conditions. As they get incorporated into quality programs on the CMS side, we would then hope to have them transfer over to the commercial side.”
Current plans at the moment only address future HIV/hepatitis C measures.
GI quality measures target endoscopy, IBD, and hep C
The first set of quality measures related to gastroenterology focus on three areas: inflammatory bowel disease, endoscopy and polyp surveillance, and hepatitis C.
In the inflammatory bowel disease measure set, consensus was reached on two measures: dealing with preventive care (corticosteroid-related iatrogenic injury – bone loss assessment) and an assessment of hepatitis B status before initiating anti–tumor necrosis factor therapy.
The five measures in the endoscopy and polyp surveillance set all relate to colonoscopy: appropriate follow-up interval for normal colonoscopy in average-risk patients; colonoscopy interval for patients with a history of adenomatous polyps; avoidance of inappropriate use; screening colonoscopy adenoma detection rate measure; and age-appropriate screening colonoscopy.
Two measures in the hepatitis C measure set include screening for hepatocellular carcinoma in patients with hepatitis C cirrhosis and one-time screening for hepatitis C virus for patients at risk.
Future areas for consideration of measure development include chronic liver disease, colorectal cancer screening, adverse events related to colonoscopy, assessing the quality of colonoscopy, gastroesophageal reflux disease and cirrhosis measures, and Barrett’s esophagus.
“I think it is an appropriate set of metrics for gastroenterology and hepatology,” said Dr. Gellad. “It was a collaborative approach. We had influence over the measures that were chosen for our specialty, but not the final say.”
Doctors, Payers Collaborate to Simplify and Align Quality Measures
The Centers for Medicare & Medicaid Services and America’s Health Insurance Plans on Feb 16 announced a set of core quality measures across seven areas that will serve as the foundation for a more uniform set of quality metrics that will be used by both public and private payers.
The CMS and AHIP are working with the National Quality Forum, medical specialty societies, employer groups, and consumer groups under an umbrella organization called the Core Quality Measures Collaborative. Together, they derived a set of measures that are “meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost,” the CMS noted in a fact sheet.
Involved medical specialty societies include the American Academy of Family Physicians, American College of Cardiology, American Heart Association, American College of Physicians, American Gastroenterological Association, HIV Medicine Association, Infectious Diseases Society of America, American Academy of Pediatrics, American Society of Clinical Oncology, and the American Medical Association.
The collaborative announced core measures in seven areas: accountable care organizations/patient centered medical homes/primary care, cardiology, gastroenterology, HIV and hepatitis C, medical oncology, obstetrics and gynecology, and orthopedics. Measures in additional areas will be released in the future and the core sets will be reviewed and updated on a regular basis.
“I think [this collaboration] strikes the best balance between what is feasible and what is desirable,” Dr. Ziad Gellad, chair of the AGA Quality Measures Committee, said in an interview.
For Medicare, Medicaid, and other public programs, the measure sets will be implemented and updated through the physician fee schedule in the coming Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs). Private payers are expected to begin implementing these quality measures as physician contracts come up for renewal.
“I think one of the biggest challenges will be how to collect these measures, because the decision about what measures to include was only driven in part by the feasibility,” Dr. Gellad said. “A large part was driven by what are the best metrics and what are most important outcomes and processes to evaluate. I think in terms of feasibility, that is going to be the next important question. How do you improve the feasibility of these measurements in practice?”
Electronic health records will play an integral part, as a FAQ released by AHIP notes that several of the measures “require that clinical data be extracted from EHRs or registries or be self-reported by clinicians.” It adds that clinicians and payers “will need to work together to create a reporting infrastructure for such measures” in areas where it is currently lacking.
The Centers for Medicare & Medicaid Services and America’s Health Insurance Plans on Feb 16 announced a set of core quality measures across seven areas that will serve as the foundation for a more uniform set of quality metrics that will be used by both public and private payers.
The CMS and AHIP are working with the National Quality Forum, medical specialty societies, employer groups, and consumer groups under an umbrella organization called the Core Quality Measures Collaborative. Together, they derived a set of measures that are “meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost,” the CMS noted in a fact sheet.
Involved medical specialty societies include the American Academy of Family Physicians, American College of Cardiology, American Heart Association, American College of Physicians, American Gastroenterological Association, HIV Medicine Association, Infectious Diseases Society of America, American Academy of Pediatrics, American Society of Clinical Oncology, and the American Medical Association.
The collaborative announced core measures in seven areas: accountable care organizations/patient centered medical homes/primary care, cardiology, gastroenterology, HIV and hepatitis C, medical oncology, obstetrics and gynecology, and orthopedics. Measures in additional areas will be released in the future and the core sets will be reviewed and updated on a regular basis.
“I think [this collaboration] strikes the best balance between what is feasible and what is desirable,” Dr. Ziad Gellad, chair of the AGA Quality Measures Committee, said in an interview.
For Medicare, Medicaid, and other public programs, the measure sets will be implemented and updated through the physician fee schedule in the coming Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs). Private payers are expected to begin implementing these quality measures as physician contracts come up for renewal.
“I think one of the biggest challenges will be how to collect these measures, because the decision about what measures to include was only driven in part by the feasibility,” Dr. Gellad said. “A large part was driven by what are the best metrics and what are most important outcomes and processes to evaluate. I think in terms of feasibility, that is going to be the next important question. How do you improve the feasibility of these measurements in practice?”
Electronic health records will play an integral part, as a FAQ released by AHIP notes that several of the measures “require that clinical data be extracted from EHRs or registries or be self-reported by clinicians.” It adds that clinicians and payers “will need to work together to create a reporting infrastructure for such measures” in areas where it is currently lacking.
The Centers for Medicare & Medicaid Services and America’s Health Insurance Plans on Feb 16 announced a set of core quality measures across seven areas that will serve as the foundation for a more uniform set of quality metrics that will be used by both public and private payers.
The CMS and AHIP are working with the National Quality Forum, medical specialty societies, employer groups, and consumer groups under an umbrella organization called the Core Quality Measures Collaborative. Together, they derived a set of measures that are “meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost,” the CMS noted in a fact sheet.
Involved medical specialty societies include the American Academy of Family Physicians, American College of Cardiology, American Heart Association, American College of Physicians, American Gastroenterological Association, HIV Medicine Association, Infectious Diseases Society of America, American Academy of Pediatrics, American Society of Clinical Oncology, and the American Medical Association.
The collaborative announced core measures in seven areas: accountable care organizations/patient centered medical homes/primary care, cardiology, gastroenterology, HIV and hepatitis C, medical oncology, obstetrics and gynecology, and orthopedics. Measures in additional areas will be released in the future and the core sets will be reviewed and updated on a regular basis.
“I think [this collaboration] strikes the best balance between what is feasible and what is desirable,” Dr. Ziad Gellad, chair of the AGA Quality Measures Committee, said in an interview.
For Medicare, Medicaid, and other public programs, the measure sets will be implemented and updated through the physician fee schedule in the coming Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs). Private payers are expected to begin implementing these quality measures as physician contracts come up for renewal.
“I think one of the biggest challenges will be how to collect these measures, because the decision about what measures to include was only driven in part by the feasibility,” Dr. Gellad said. “A large part was driven by what are the best metrics and what are most important outcomes and processes to evaluate. I think in terms of feasibility, that is going to be the next important question. How do you improve the feasibility of these measurements in practice?”
Electronic health records will play an integral part, as a FAQ released by AHIP notes that several of the measures “require that clinical data be extracted from EHRs or registries or be self-reported by clinicians.” It adds that clinicians and payers “will need to work together to create a reporting infrastructure for such measures” in areas where it is currently lacking.
Doctors, payers collaborate to simplify and align quality measures
The Centers for Medicare & Medicaid Services and America’s Health Insurance Plans on Feb 16 announced a set of core quality measures across seven areas that will serve as the foundation for a more uniform set of quality metrics that will be used by both public and private payers.
The CMS and AHIP are working with the National Quality Forum, medical specialty societies, employer groups, and consumer groups under an umbrella organization called the Core Quality Measures Collaborative. Together, they derived a set of measures that are “meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost,” the CMS noted in a fact sheet.
Involved medical specialty societies include the American Academy of Family Physicians, American College of Cardiology, American Heart Association, American College of Physicians, American Gastroenterological Association, HIV Medicine Association, Infectious Diseases Society of America, American Academy of Pediatrics, American Society of Clinical Oncology, and the American Medical Association.
The collaborative announced core measures in seven areas: accountable care organizations/patient centered medical homes/primary care, cardiology, gastroenterology, HIV and hepatitis C, medical oncology, obstetrics and gynecology, and orthopedics. Measures in additional areas will be released in the future and the core sets will be reviewed and updated on a regular basis.
“I think [this collaboration] strikes the best balance between what is feasible and what is desirable,” Dr. Ziad Gellad, chair of the AGA Quality Measures Committee, said in an interview.
For Medicare, Medicaid, and other public programs, the measure sets will be implemented and updated through the physician fee schedule in the coming Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs). Private payers are expected to begin implementing these quality measures as physician contracts come up for renewal.
“I think one of the biggest challenges will be how to collect these measures, because the decision about what measures to include was only driven in part by the feasibility,” Dr. Gellad said. “A large part was driven by what are the best metrics and what are most important outcomes and processes to evaluate. I think in terms of feasibility, that is going to be the next important question. How do you improve the feasibility of these measurements in practice?”
Electronic health records will play an integral part, as a FAQ released by AHIP notes that several of the measures “require that clinical data be extracted from EHRs or registries or be self-reported by clinicians.” It adds that clinicians and payers “will need to work together to create a reporting infrastructure for such measures” in areas where it is currently lacking.
The Centers for Medicare & Medicaid Services and America’s Health Insurance Plans on Feb 16 announced a set of core quality measures across seven areas that will serve as the foundation for a more uniform set of quality metrics that will be used by both public and private payers.
The CMS and AHIP are working with the National Quality Forum, medical specialty societies, employer groups, and consumer groups under an umbrella organization called the Core Quality Measures Collaborative. Together, they derived a set of measures that are “meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost,” the CMS noted in a fact sheet.
Involved medical specialty societies include the American Academy of Family Physicians, American College of Cardiology, American Heart Association, American College of Physicians, American Gastroenterological Association, HIV Medicine Association, Infectious Diseases Society of America, American Academy of Pediatrics, American Society of Clinical Oncology, and the American Medical Association.
The collaborative announced core measures in seven areas: accountable care organizations/patient centered medical homes/primary care, cardiology, gastroenterology, HIV and hepatitis C, medical oncology, obstetrics and gynecology, and orthopedics. Measures in additional areas will be released in the future and the core sets will be reviewed and updated on a regular basis.
“I think [this collaboration] strikes the best balance between what is feasible and what is desirable,” Dr. Ziad Gellad, chair of the AGA Quality Measures Committee, said in an interview.
For Medicare, Medicaid, and other public programs, the measure sets will be implemented and updated through the physician fee schedule in the coming Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs). Private payers are expected to begin implementing these quality measures as physician contracts come up for renewal.
“I think one of the biggest challenges will be how to collect these measures, because the decision about what measures to include was only driven in part by the feasibility,” Dr. Gellad said. “A large part was driven by what are the best metrics and what are most important outcomes and processes to evaluate. I think in terms of feasibility, that is going to be the next important question. How do you improve the feasibility of these measurements in practice?”
Electronic health records will play an integral part, as a FAQ released by AHIP notes that several of the measures “require that clinical data be extracted from EHRs or registries or be self-reported by clinicians.” It adds that clinicians and payers “will need to work together to create a reporting infrastructure for such measures” in areas where it is currently lacking.
The Centers for Medicare & Medicaid Services and America’s Health Insurance Plans on Feb 16 announced a set of core quality measures across seven areas that will serve as the foundation for a more uniform set of quality metrics that will be used by both public and private payers.
The CMS and AHIP are working with the National Quality Forum, medical specialty societies, employer groups, and consumer groups under an umbrella organization called the Core Quality Measures Collaborative. Together, they derived a set of measures that are “meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost,” the CMS noted in a fact sheet.
Involved medical specialty societies include the American Academy of Family Physicians, American College of Cardiology, American Heart Association, American College of Physicians, American Gastroenterological Association, HIV Medicine Association, Infectious Diseases Society of America, American Academy of Pediatrics, American Society of Clinical Oncology, and the American Medical Association.
The collaborative announced core measures in seven areas: accountable care organizations/patient centered medical homes/primary care, cardiology, gastroenterology, HIV and hepatitis C, medical oncology, obstetrics and gynecology, and orthopedics. Measures in additional areas will be released in the future and the core sets will be reviewed and updated on a regular basis.
“I think [this collaboration] strikes the best balance between what is feasible and what is desirable,” Dr. Ziad Gellad, chair of the AGA Quality Measures Committee, said in an interview.
For Medicare, Medicaid, and other public programs, the measure sets will be implemented and updated through the physician fee schedule in the coming Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs). Private payers are expected to begin implementing these quality measures as physician contracts come up for renewal.
“I think one of the biggest challenges will be how to collect these measures, because the decision about what measures to include was only driven in part by the feasibility,” Dr. Gellad said. “A large part was driven by what are the best metrics and what are most important outcomes and processes to evaluate. I think in terms of feasibility, that is going to be the next important question. How do you improve the feasibility of these measurements in practice?”
Electronic health records will play an integral part, as a FAQ released by AHIP notes that several of the measures “require that clinical data be extracted from EHRs or registries or be self-reported by clinicians.” It adds that clinicians and payers “will need to work together to create a reporting infrastructure for such measures” in areas where it is currently lacking.
