Quality Measurement

As the health care system moves toward one emphasizing the value of care over the volume of care, quality measurement can promote system-wide improvement. The focus of measure sets is typically limited to the clinical conditions of a few at-risk populations. Measurement influences priorities and care delivery to the potential detriment of patients with conditions outside the scope of measure sets. This could result in inappropriate care, which includes both overuse and underuse of services.

To address widespread gaps in accountable care measure sets, the following three types of measures should be used and promoted in quality measure development:

  • Outcome measures, which are meaningful to patients and providers, allow for flexibility and innovation in improving care, and can efficiently replace multiple process measures;
  • Cross-cutting measures, which assess care across conditions, settings and time; and
  • Patient-reported measures, which emphasize the outcomes that matter most to patients, such as functional status and quality of life.

The National Pharmaceutical Council has:

  • Served as a convener on this issue by bringing together thought leaders and patient groups for a real conversation about how to better communicate and include patients in the process and improve outcomes at lower costs;
  • Identified gaps in quality measures and offered recommendations on how to fill those gaps; and,
  • Helped create an online, interactive continuing education series, “Healthcare Quality: Measurement and Implications Series,” which addresses basic information about quality measurement, and in the second module, takes a more in-depth look into the role quality measures play in the biopharmaceutical industry.

Quality measures will continue to play an important role as the needs and priorities of a value-based health system evolve. That’s why all stakeholders must continue to have an open dialogue to address gaps and work toward changes in quality measures that can truly improve value-based care models. While just one tool, quality measures have the potential to be an important element in improving patient outcomes and lowering costs across our system.