quality measures

CMS

physician compare

Issue: Volume 65-Issue 10-October 2019-ISSN 2640-5245

Report

Three (3) wound care quality measures developed by the Alliance of Wound Care Stakeholders and the US Wound Registry (USWR) are now included on the Centers of Medicare and Medicaid Services’ (CMS) Physician Compare, a website created to enable patients to make informed decisions when selecting health care providers who participate in Medicare by comparing quality data between individual physicians, group practices, and Accountable Care Organizations. The quality performance data publicly available on the site also incentivize clinicians to maximize their performance scores.

The updated Physician Compare site now incorporates 2017 Quality Payment Program data and includes, for the first time, performance data on 12 standard quality measures from the Merit Based Incentive Payment Program (MIPS) and 11 specialty-specific measures developed by various Qualified Clinical Data Registries (QCDRs).

Nearly every medical specialty has launched a QCDR to facilitate MIPS participation by their members and to develop quality measures relevant to their patients and practice. Among the 40+ medical specialty registries, only 6 QCDRs had specialty-specific measures selected by the CMS for inclusion on

Physician Compare. Of the 11 total QCDR specialty measures that were chosen, 3 are wound care measures; these include:

 1) adequate offloading of diabetic foot ulcer at each treatment visit;

2) adequate compression of venous leg ulcers at each treatment visit; and

 3) vascular assessment of patients with chronic leg ulcers.

No other QCDR had 3 measures selected for the Physician Compare site, suggesting a growing appreciation by the CMS of the impact of diabetic foot and venous leg ulcers on Medicare beneficiaries.

To be eligible for inclusion on the CMS Physician Compare website, a quality measure must have been in use for at least 3 years in order to for the CMS to establish national benchmark rates, and it must have been reported by a sufficient number of practitioners. Thus, at least 3 years of dedicated work by a QCDR is required for a measure to be eligible for Physician Compare. Other organizations whose QCDR measures were selected include the American Academy of Neurology, the Anesthesia Business Group, the American College of Emergency Physicians, the Primary (Care) Practice Research Network — organizations that represent powerful, well-organized, and well-funded specialties.

Because wound management is not a recognized subspecialty, when the QCDR initiative began in 2014, the CMS agreed (after much proactive advocacy) for the Alliance of Wound Care Stakeholders to act in lieu of a specialty society, given its role as a convener of all the clinical associations relevant to wound management. The prominent positioning of wound management quality measures on the newly updated Physician Compare site is the result of many years of work by the Alliance and USWR to increase CMS’ attention to chronic wound care and to improve the quality of care provided to patients. With the inclusion of this data on the Physician Compare site,

consumers can now consider this information when selecting health care providers.

The easily viewable information is designed to educate patients.  Downloadable files also are accessible to clinicians and have reportedly also been used by private payers in a variety of ways (eg, to calculate Value Based Purchasing calculations), demonstrating the value of comparative performance data across a range of stakeholders.

The USWR facilitates merit-based payment reporting for wound care practitioners and develops specialty-specific quality measures and clinical practice improvement activities relevant to wound management and nutrition. The Alliance of Wound Care Stakeholders is an association of physician and clinical organizations focused on promoting quality care and access to procedures and technologies for patients with wounds through advocacy and educational outreach in the regulatory, legislative, and public arenas. For more information, please visit: woundcarestakeholders.org and uswoundregistry.com.