Healthcare Informatics (04/19/18) Raths, David
Only 37 percent of 86 measures cited as relevant to ambulatory general internal medicine in the Quality Payment Program for 2017 were actually valid, according to a new study from the American College of Physicians (ACP) Performance Measurement Committee. Meanwhile, 35 percent were rated not valid and 28 percent were of uncertain validity. The study, published in the New England Journal of Medicine, observed: "Although most physicians view the delivery of high-quality care as a professional imperative, performance-measurement activities face increasing resistance from physicians and some policymakers who believe that current measures are not meaningful." In response to these concerns, the ACP's Performance Measurement Committee developed criteria to assess the validity of performance measures by using a modified version of the method developed at RAND and UCLA for evaluating the benefits and harms of a medical intervention. Among the 30 measures rated as not valid, 19 were judged to have insufficient evidence to support them. For example, the report said the U.S. Preventive Services Task Force has found insufficient evidence to warrant routine screening as called for by MIPS measure 181, "Elder Maltreatment Screen and Follow-Up." ACP also found that greater percentages of National Committee for Quality Assurance-developed and National Quality Forum-endorsed measures were deemed valid (59 percent and 48 percent, respectively, vs. 27 percent for non-endorsed measures), and smaller percentages were deemed not valid (7 percent and 22 percent, vs. 49 percent for non-endorsed measures).