Reporting quality measures is costly, not useful for physician practices, survey finds

Reporting on quality metrics is a time-consuming task for physicians and their staff. U.S. physician practices in four common specialties spend, on average, 785 hours per physician each year on reporting quality measures. Overall, that time costs practices an estimated $15.4 billion each year, according to a survey in Health Affairs.

Researchers surveyed 395 orthopedic, primary care, cardiology and multispecialty physician practices that are members of the Medical Group Management Association. Survey questions asked for details of time spent on activities related to reporting and inspecting quality data, as well as practice leaders' perception on how useful those measures are.

One troubling finding is the most time — 12.5 hours of physician and staff time per physician per week — was spent on entering information into the medical record for the sole purpose of reporting for quality measures from external entities.

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Additionally, 81 percent of practices reported their effort in reporting on quality measures is increasing compared to three years ago, and 46 percent called it a significant burden to deal with similar, but different, quality measures. For instance, the study authors noted the Medicare Shared Savings Program metric for poor diabetes control is a hemoglobin A1c at or below 8 percent, while the Healthcare Effectiveness Data and Information Set puts the level at or below 9 percent.

Even though physician practices are putting a lot of time and effort into reporting on quality metrics, most of them aren't using the information to improve quality. The survey found that just 28 percent of surveyed practices used the quality scores to focus quality improvement activities, and just 27 percent said current measures were moderately or strongly representative of the quality of care.

"There is much to gain from quality measurement, but the current system is far from being efficient and contributes to negative physician attitudes toward quality measures," the authors wrote. They noted that rapid improvements to the system will be difficult to make, but urged focus on the area. "Our data suggest that U.S. healthcare leaders should make these efforts a priority."

Halee Fischer-Wright, MD, president and CEO of MGMA, said in a statement, "This study proves that the current top-down approach has failed. It serves no purpose to have over 3,000 competing measures of quality across government and private initiatives. Although standardization is critical, if measures don't improve patient care, it's an exercise in futility. As the largest contributor to the problem, the federal government needs to get out of the business of dictating patient care through wasteful mandates and create simplified systems to support medical practices in improving quality across the country."

Note: A previous version of this article stated quality reporting costs $14.5 billion annually. The real cost is $15.4 billion. We regret this error.

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