The general public expects that "better healthcare quality" means better outcomes. Most doctors want their quality metrics to be outcome measures. The quality metrics that CMS uses most are process measures. Can you check off the box? Did you order this or that intervention for the correct population? Did you get everyone their vaccines? Did you follow the protocol? If you did the things, you get lots of quality badges from NCQA and their HEDIS audits. And you guessed it, "the things" you are checking off usually means more $$ for their buddies in the industry. When a provider or a healthcare entitiy like a hospital has higher quality scores, that doesn't necessarily mean that their quality of care is better. It means they adhere to published protocols well, and they probably are paid better than those who do not have the fancy badges. Higher quality scores mean higher reimbursment from CMS and some insurance plans.
All the data collected about this or that quality metric has nothing to do with a physician treating patients effectively and well and everything to do with gathering useless data for the AI nerds to create nice reports to try to show big business medicine, big pharma, and the governemt are doing something useful to improve healthcare. Toss the PR data and go back to letting doctors be doctors. Patients recognize the difference between quality metrics and the care they receive from a good patient/physician relationship.
The general public expects that "better healthcare quality" means better outcomes. Most doctors want their quality metrics to be outcome measures. The quality metrics that CMS uses most are process measures. Can you check off the box? Did you order this or that intervention for the correct population? Did you get everyone their vaccines? Did you follow the protocol? If you did the things, you get lots of quality badges from NCQA and their HEDIS audits. And you guessed it, "the things" you are checking off usually means more $$ for their buddies in the industry. When a provider or a healthcare entitiy like a hospital has higher quality scores, that doesn't necessarily mean that their quality of care is better. It means they adhere to published protocols well, and they probably are paid better than those who do not have the fancy badges. Higher quality scores mean higher reimbursment from CMS and some insurance plans.
All the data collected about this or that quality metric has nothing to do with a physician treating patients effectively and well and everything to do with gathering useless data for the AI nerds to create nice reports to try to show big business medicine, big pharma, and the governemt are doing something useful to improve healthcare. Toss the PR data and go back to letting doctors be doctors. Patients recognize the difference between quality metrics and the care they receive from a good patient/physician relationship.
Good thoughts! Definitely some benefits from answering directly to the patient than a 3rd party payer.