Issue link: https://beckershealthcare.uberflip.com/i/824946
62 QUALITY IMPROVEMENT & MEASUREMENT 51 Quality Measures Should Be Removed From Federal Programs, MAP Says By Heather Punke T he National Quality Forum's Measure Applications Partner- ship has recommended the removal of 51 of the 240 quality measures used in seven federal programs. MAP is a public-private partnership that provides guidance to HHS on quality and efficiency of measures used in federal performance-based payment programs. It released its new recommendations March 16. e measures recommended for removal no longer drive improve- ment of care or do not meet the scientific criteria required for en- dorsement from NQF, according to Harold Pincus, MD, director of quality and outcomes research at NewYork-Presbyterian Hospital in New York City and co-chair of the MAP Coordinating Committee. MAP recommends removing measures from the following programs: • End Stage Renal Disease Quality Incentive Program: Remove four of the 18 current measures • Prospective Payment System-Exempt Cancer Hospital Quality Reporting Program: Remove four of the 17 current measures • Ambulatory Surgery Center Quality Reporting Program: Re- move two of the 15 current measures • Inpatient Psychiatric Facility Quality Reporting Program: Re- move seven of the 20 current measures • Outpatient Quality Reporting Program: Remove 13 of the 29 current measures • Inpatient Quality Reporting Program: Remove six of the 62 cur- rent measures • Home Health Quality Reporting Program: Remove 15 of the 79 current measures Removing these measures would also reduce the reporting burden on physicians, hospitals and other providers, according to Dr. Pincus and Ronald Walters, MD, associate vice president of medical operations and informatics at MD Anderson Cancer Center in Houston and co- chair of MAP Hospital Work Group. "Wouldn't you rather have your doctor spend more time caring for you rather than on paperwork that doesn't help to improve your care?" Dr. Walters said during a press call March 16. In addition to recommending measures for removal, MAP also evalu- ated measures under consideration for the Merit-Based Incentive Pay- ment System and the Medicare Shared Savings Program. MAP noted higher-value measures, including outcome measures, are needed in the MIPS and MSSP programs, but the group did not rec- ommend any measures be removed from those programs. n Dr. Peter Pronovost: This Unnecessary Regulation Doesn't Benefit Patients and Costs $500M Each Year By Heather Punke T he federal government requires preoperative testing before cat- aract surgery, which costs the healthcare system $500 million annu- ally — but has no positive effect on pa- tient health, according to a blog post in The Wall Street Journal. Peter Pronovost, MD, senior vice pres- ident with Baltimore-based Johns Hopkins Medicine and director of the Armstrong Institute for Patient Safety and Quality, wrote the piece pub- lished in April. He cites a 17-year-old study in The New England Journal of Medicine that found preoperative medical testing before cataract surgery "does not measurably increase the safety of the surgery." Dr. Pronovost and his colleague Oliver Schein, MD, an oph- thalmologist, also wrote a study titled, "A Preoperative Medical History and Physical Should Not Be a Requirement for All Cataract Patients," published in the Journal of General Internal Medi- cine in March. Despite robust data supporting this conclusion, the tests "continue to be required by the federal government and accrediting organizations before every cataract surgery and other low- risk elective procedures," Dr. Prono- vost writes. Instead of performing the costly tests on every cataract patient, those who need it can be identified with a check- list, he notes. Dr. Pronovost writes the requirement may not be the only regulation that could be revamped or scrapped en- tirely without jeopardizing patient safety. For instance, CMS recently eliminated a regulation preventing nutritionists from writing diet orders. "Wise regulations have accomplished much good in healthcare," he con- cludes. "Still, CMS should establish a process to identify, evaluate and re- vise or remove regulations that corset clinicians, increase costs and place burdens on patients without clear benefits to safety or quality." n