Quality measures are a key element of value-based payment and can help providers and payers identify improvement opportunities, track effectiveness of improvements over time, and set rewards for maintaining high-quality care while lowering costs. Gaps in the quality measures used by accountable care programs to assess cancer care may obscure problems in care delivery and lead to missed opportunities for improving patient outcomes, according to a new study conducted by Discern and sponsored by the National Pharmaceutical Council (NPC). The study, “Improving Oncology Quality Measurement in Accountable Care: Filling Gaps in Cross-Cutting Measures,” was published in the February edition of the Journal of Managed Care & Specialty Pharmacy.
The JMCP article, which was co-authored by Discern, NPC staff, Dr. Mark McClellan of the Duke-Margolis Center for Health Policy, and Dr. Robert S. Miller of the American Society of Clinical Oncology (ASCO), examines gaps in available cancer care measures and measure sets for programs such as the Medicare Oncology Care Model (OCM). These findings build on an assessment of specialty care measure gaps that was conducted by Discern and NPC in 2014.
The oncology measures study examined quality measure gaps across 10 high-priority types of cancers and cross-cutting issues such as quality of life, pain management, behavioral health, and utilization of care. The study’s findings and recommendations, which are based on the conclusions reached by a roundtable of payers, providers, patient advocates, health care purchasers, and quality measurement experts, emphasize cross-cutting measures, such as patient-reported outcomes (PROs), clinical outcomes, safety, evaluation and management, and essential structures.