[{"innerBlocks":[],"name":"core\/freeform","postId":3024,"blockType":{"name":"core\/freeform","keywords":[],"attributes":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"providesContext":[],"usesContext":[],"selectors":[],"supports":{"className":false,"customClassName":false,"reusable":false},"styles":[],"variations":[],"apiVersion":3,"title":"Classic","description":"Use the classic WordPress editor.","category":"text"},"originalContent":"As the healthcare industry transitions to value-based care, quality measurement has become ubiquitous. However, little is known in healthcare about the exact costs of collecting and analyzing this kind of data, as well as interpreting results for particular measures.

That\u2019s the contention of Mark Schuster, MD, chief of general pediatrics and vice chair for health policy in the Department of Medicine at Boston Children\u2019s Hospital. While collecting, processing, analyzing and reporting quality data is costly, healthcare organizations are not including costs in decisions about which measures to use, he says.

Writing in a viewpoint article published online<\/a> late last week in the journal JAMA, Schuster and two co-authors make the case that \u201cmeasures are everywhere,\u201d but the \u201ccost of specific measures has received limited attention\u201d and \u201cis not formally considered when evaluating and selecting measures, in no small part because that cost is usually unknown.\u201d

Also See<\/b>: How to improve reporting of quality measures<\/a>

However, as the industry moves from fee-for-service to value-based payment, Schuster makes the case that without understanding the costs of specific measures, healthcare organizations cannot fully assess their value.

\u201cOur hospital\u2014and other hospitals\u2014when negotiating with insurance companies about what measures might be used in risk-bearing contracts, does not have that information available,\u201d he says. \u201cThere are many important factors that go into selecting quality measures, and one of them needs to be cost.\u201d

Nonetheless, Schuster and his colleagues point out in their opinion piece that the National Quality Forum\u2014which vets many measures used by healthcare organizations\u2014does not require those who develop measures to report cost data. In addition, they reference the fact that limited information is available about whether and how the Centers for Medicare and Medicaid Services factors the cost of measures into hospital value-based purchasing.

The authors note that the Office of Management and Budget does estimate costs for measurement initiatives. However, they say these estimates focus on the annual burden of entire measurement and reporting programs\u2014such as the Physician Quality Reporting System\u2014rather than the burden of individual measures or the burden for individual institutions.

\u201cWhen selecting measures, hospitals and clinicians have even less access to cost information than these larger institutions,\u201d states the article.

At the same time, Schuster adds that \u201cour purpose is not to suggest that cost is the most important factor\u2014it\u2019s just a factor, but it\u2019s one that has been missing from most of the discussion.\u201d

To address this shortfall, he and his colleagues call for the development of standards for the units, timeframe and other variables needed for consistent cost comparisons across multiple measures.

\u201cOrganizations endorsing measures should include cost estimates in measure descriptions,\u201d states the article. \u201cTo start, these organizations could set a deadline after which measure submissions must incorporate cost information. They might create a pilot program to devise and test standard specifications for cost information and to develop methodologies for collecting cost data and estimating costs. Even general estimates could inform measure selection, and the science of cost estimation would likely improve rapidly if measuring cost became a routine component of measure development.\u201d

Schuster emphasizes that \u201cwe\u2019re not suggesting that National Quality Forum instantly declare that everyone submit their measures with the cost\u2014there needs to be a period of figuring out how to measure costs and how to have standardization of cost measurement across measures.\u201d","saveContent":"As the healthcare industry transitions to value-based care, quality measurement has become ubiquitous. However, little is known in healthcare about the exact costs of collecting and analyzing this kind of data, as well as interpreting results for particular measures.

That\u2019s the contention of Mark Schuster, MD, chief of general pediatrics and vice chair for health policy in the Department of Medicine at Boston Children\u2019s Hospital. While collecting, processing, analyzing and reporting quality data is costly, healthcare organizations are not including costs in decisions about which measures to use, he says.

Writing in a viewpoint article published online<\/a> late last week in the journal JAMA, Schuster and two co-authors make the case that \u201cmeasures are everywhere,\u201d but the \u201ccost of specific measures has received limited attention\u201d and \u201cis not formally considered when evaluating and selecting measures, in no small part because that cost is usually unknown.\u201d

Also See<\/b>: How to improve reporting of quality measures<\/a>

However, as the industry moves from fee-for-service to value-based payment, Schuster makes the case that without understanding the costs of specific measures, healthcare organizations cannot fully assess their value.

\u201cOur hospital\u2014and other hospitals\u2014when negotiating with insurance companies about what measures might be used in risk-bearing contracts, does not have that information available,\u201d he says. \u201cThere are many important factors that go into selecting quality measures, and one of them needs to be cost.\u201d

Nonetheless, Schuster and his colleagues point out in their opinion piece that the National Quality Forum\u2014which vets many measures used by healthcare organizations\u2014does not require those who develop measures to report cost data. In addition, they reference the fact that limited information is available about whether and how the Centers for Medicare and Medicaid Services factors the cost of measures into hospital value-based purchasing.

The authors note that the Office of Management and Budget does estimate costs for measurement initiatives. However, they say these estimates focus on the annual burden of entire measurement and reporting programs\u2014such as the Physician Quality Reporting System\u2014rather than the burden of individual measures or the burden for individual institutions.

\u201cWhen selecting measures, hospitals and clinicians have even less access to cost information than these larger institutions,\u201d states the article.

At the same time, Schuster adds that \u201cour purpose is not to suggest that cost is the most important factor\u2014it\u2019s just a factor, but it\u2019s one that has been missing from most of the discussion.\u201d

To address this shortfall, he and his colleagues call for the development of standards for the units, timeframe and other variables needed for consistent cost comparisons across multiple measures.

\u201cOrganizations endorsing measures should include cost estimates in measure descriptions,\u201d states the article. \u201cTo start, these organizations could set a deadline after which measure submissions must incorporate cost information. They might create a pilot program to devise and test standard specifications for cost information and to develop methodologies for collecting cost data and estimating costs. Even general estimates could inform measure selection, and the science of cost estimation would likely improve rapidly if measuring cost became a routine component of measure development.\u201d

Schuster emphasizes that \u201cwe\u2019re not suggesting that National Quality Forum instantly declare that everyone submit their measures with the cost\u2014there needs to be a period of figuring out how to measure costs and how to have standardization of cost measurement across measures.\u201d","order":0,"get_parent":{},"attributes":[],"attributesType":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"dynamicContent":""}]

Researchers push release of cost data that undergirds care decisions

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