Study Offers Solutions for Filling Gaps in Accountable Care Measure Sets

For Immediate Release
Contact: Andrea Hofelich,, 202-827-2078 

(Washington, DC, October 13, 2015)Measurement in accountable care programs is essential for promoting quality improvement and balancing financial incentives, but gaps in measurement can result in missed opportunities to improve patient care and health systems. A new, peer-reviewed study published in The American Journal of Managed Care explores measurement gaps for high-priority conditions and identifies ways to improve measure sets.

“These gaps in measures present opportunities for supporting improvement in quality and cost of care and helping consumers and purchasers make better decisions,” said co-author Mark McClellan, MD, PhD, senior fellow and director of the Health Care Innovation and Value Initiative at the Brookings Institution. “Understanding where and how we can address these gaps can help to make accountable care systems more effective.”

The study, “Solutions for Filling Gaps in Accountable Care Measure Sets,” was conducted jointly by experts from the National Pharmaceutical Council (NPC), Discern Health, the Brookings Institution and the American Medical Group Association. Researchers examined gaps in accountable care measures as compared with evidence-based guidelines for 20 prevalent and costly conditions, such as breast cancer, diabetes, HIV, and heart disease. The findings were reviewed via a roundtable discussion with national thought leaders. Some conditions have a number of quality measures, while others have none.

“Ideally, meaningful measures would be available for all conditions and dimensions of care, but the data collection would be overwhelming for providers,” said Discern Health Partner Tom Valuck, MD, JD, who also is a study author. “We recommend using a mix of priority measure types and innovative measurement designs.”

Specifically, to address widespread gaps in accountable care measure sets, the researchers suggested using and promoting the development of the following three types of measures:

  • 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 researchers also recognized that accountable care systems use measures at multiple levels of management. By using layered and modular approaches, accountable care systems can customize and optimize measurement efforts by focusing the measures on specific purposes, such as external accountability or internal improvement for the layered approach or a specific subpopulation for the modular approach.

“Our research has shown that quality measures need more breadth, more depth and new designs,” said NPC Chief Science Officer Robert W. Dubois, MD, PhD, one of the study’s authors. “Utilizing these types of preferred quality measures and novel approaches to measurement is a step in the right direction to attaining valuable measurement in this evolving health care system.”

The paper follows on last year’s white paper, “Accountable Care Measures for High-Cost Specialty Care and Innovative Treatment: You Get What You Pay For—Improving Measures for Accountable Care,” and related conference, “Mind the Gap: Improving Quality Measurement in Accountable Care Systems.” Both the white paper and conference took an in-depth look at the challenges with quality measures, and are supplemented with video interviews with experts. In addition, NPC and the University of Maryland School of Pharmacy have developed a continuing education course on quality measures.

About the National Pharmaceutical Council
The National Pharmaceutical Council is a health policy research organization dedicated to the advancement of good evidence and science, and to fostering an environment in the United States that supports medical innovation. Founded in 1953 and supported by the nation’s major research-based pharmaceutical companies, NPC focuses on research development, information dissemination, and education on the critical issues of evidence, innovation and the value of medicines for patients. For more information, visit and follow NPC on Twitter @npcnow.

About Discern Health
Discern Health is a consulting firm that works with clients across the private and public sectors to improve health and health care. Discern’s focus is enhancing the value of health care services through quality-based payment and delivery models. These models align performance with incentives by rewarding doctors, hospitals, suppliers, and patients for working together to improve health outcomes and health care processes, while lowering total costs.

Discern has been involved in value-based purchasing projects since its founding in 2004. Discern’s clients include a range of organizations—pharmaceutical companies, providers, payers, policymakers, purchasers, and national thought leadership organizations—that are driving the agenda for change in health care. More information on Discern is available at