Quality Measurement and Reporting

Measurement & Public Reporting

Creating a single source of data about primary care quality, available at the practice-level, is an essential building block in virtually all proposed approaches to reforming our health care system. In order to align clinicians, health plans, public and private purchasers and patients in a market that produces better outcomes, we must have meaningful, apples-to-apples comparison data about the quality of care that is provided at the clinic level across all payers. This data:

  • Helps clinicians identify opportunities and paths to improve the care they provide
  • Gives purchasers and plans a means to support providers that invest in practices redesigned for quality outcomes
  • Engages consumers in seeking high quality care and helps motivate behaviors that can improve outcomes

Measures of Quality

An expert committee of physician, plan, purchaser and consumer representatives has identified principles for measure selection and a first set of Oregon measures. These are a subset of the national Ambulatory Quality Alliance Starter Set endorsed by the Institute of Medicine. Measures will focus on

  • diabetes
  • cardiovascular disease
  • asthma
  • depression
  • prevention

Data Sources for Measuring Quality

Oregon will use basic process measures (e.g. was an A1c performed) from administrative claims, pooled across all health plans, to provide statistically valid information about processes for virtually all providers groups. The Oregon Clearinghouse pilot demonstrated that a single consolidated report of claims data provides actionable information for many providers, including those with EHRs.

Physicians will be encouraged to voluntarily provide clinical data for expanded measures (e.g. what proportion of diabetes patients are in control) pulled from clinics’ disease monitoring systems and/or computerized electronic health records provides rich information about care quality and outcomes. A standard methodology makes this self-reported data from physician groups useful for benchmarking and encourages investment in the tools that support redesigned practices.

Patient experience survey data provides information that only consumers have about their health outcomes and the quality of their interaction with their providers.

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