Loose MIPS Sink…Physicians
Here’s some recent news about quality measures:
- The American College of Physicians, responding to provider concerns about current performance measurement policies, published an analysisof the Merit-based Incentive Payment System in the New England Journal of Medicine and found the majority of measures for ambulatory internal medicine are not valid by the ACP’s own criteria.
- Of the 86 performance measures included in MACRA’s MIPS track and Quality Payment Program, ACP deemed 32 to be valid, 30 to be not valid and 24 of “uncertain validity.”
- ACP cited the National Academy of Medicine’s clinical practice guidelines as a model for setting a single set of standards that would allow performance measures to be properly assessed before being put into practice.
So, wait, this stuff doesn’t work? Hmmm. Well, then say we have the insurers and government double down on their use then:
CMS recently announced a new funding opportunity for the development, improvement and expansion of quality measures for QPP. The agency said it will provide up to $30 million in funding and technical assistance to clinicians, patients and other stakeholders working on performance measures over the next three years.
Brilliant. Let’s keep rearranging chairs on the Titanic.
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Whats good for the goose is good for the gander. Sounds like the panel making these “quality measures” need to have quality measures applied to their own work, which I guess is the gist of the article.
Standardized quality measures in medicine are one of the dumbest ideas I have ever heard of and I for one have absolutely no interest in participating in them. I will not attempt to get my 90 year old diabetic to an a1c of 7 and in the process kill them by giving them a hypoglycemic episode that fractures their hip.
The future learning opportunities are:
1) To deal with so many conflicting quality measures you don’t give a rat’s ass about them except if they gets you a whippin’.
2). Don’t diagnose. Diagnosis causes treatment causes quality measurements. You can’t fail when you don’t try.
3) To get the point that the system requires failure. Failure causes scandal causes quality measures and makes for jobs.
Realizing that alleviation of human suffering is a sideshow to modern medicine’s big top.