Quality and Patient Safety
Quality Improvement: Why Do We Need It?
- Current payment systems do not consider quality in determining reimbursement.
- The incentives the current reimbursement systems provide sometimes promote poor quality care.
- The present fee-for-service payment systems pay providers based on the number and complexity of services provided to patients without regard to quality, efficiency, or impact on health outcomes. Pay for performance has been proposed as one strategy for correcting this deficiency.
Achieving Quality Care for Our Frail Elders: Quality Measures and Complexity
Since the Institute of Medicine released its ground-breaking report, Crossing the Quality Chasm: A New Health System for the 21st Century, in 2001, a great deal of energy has been focused on quality measurement and performance improvement. The twin goals of this work have been to promote higher quality care and create a systematic approach for rewarding providers who provide quality care. Much of the emphasis and focus has been on developing quality measures that are specific to a single disease or condition with little attention paid to developing measures for those with multiple chronic illnesses. In addition, some measures specifically exclude those age 65 and over (and diabetics age 75 and over) from being measured precisely because of the complexity they present.
Quality measures for vulnerable older adults and frail elders should be constructed so that multiple chronic illnesses are accounted for and providers are rewarded for treatment that improves quality of life.
Working to Advance Quality & Patient Safety Issues
The Society has been active in measure review and development with various quality organizations including, but not limited to:
- National Quality Forum (NQF)
The NQF is a not-for-profit organization that works to catalyze improvements in healthcare through fulfillment of its three-part mission: Setting national priorities and goals for performance improvement; Endorsing national consensus standards for measuring and publicly reporting on performance; and Promoting the attainment of national goals through education and outreach programs.
The PCPI is a not-for-profit organization committed to improving the quality, safety and value of care delivered to patients in the United States by taking the lead in the development, testing and maintenance of measures and measurement resources for physicians and non-physicians.
- National Committee for Quality Assurance (NCQA)
The NCQA is a private, 501(c)(3) not-for-profit organization dedicated to improving health care quality. Since its founding in 1990, NCQA has been a central figure in driving improvement throughout the health care system, helping to elevate the issue of health care quality to the top of the national agenda.
Through these organizations, the AGS has served on committees, participated on workgroups, and submitted comments and votes on measures.