Measuring quality and value in genetic counseling: The current landscape and future directions.

Genetic counselors strive to provide high-quality genetic services. To do so, it is essential to define quality in genetic counseling and identify opportunities for improvement. This Professional Issues article provides an overview of the evaluation of healthcare quality in genetic counseling.

Improving Oncology Quality Measurement in Accountable Care: Filling Gaps with Cross-Cutting Measures.

Unlabelled: Payment for health care services, including oncology services, is shifting from volume-based fee-for-service to value-based accountable care. The objective of accountable care is to support providers with flexibility and resources to reform care delivery, accompanied by accountability for maintaining or improving outcomes while lowering costs. These changes depend on health care payers, systems, physicians, and patients having meaningful measures to assess care delivery and outcomes and to balance financial incentives for lowering costs while providing greater value.

Solutions for filling gaps in accountable care measure sets.

Objectives: A primary objective of accountable care is to support providers in reforming care to improve outcomes and lower costs. Gaps in accountable care measure sets may cause missed opportunities for improvement and missed signals of problems in care. Measures to balance financial incentives may be particularly important for high-cost conditions or specialty treatments.

The relationship between organizational culture and practice systems in primary care.

The patient-centered medical home is an approach to comprehensive primary care relying on well-developed systems. Research has shown that for practices to meet patient-centered medical home requirements, care models may need to be redesigned. However, there is a dearth of information about what factors are important to achieve this goal.

Availability of data for measuring physician quality performance.

Objective: To evaluate measurement of physician quality performance, which is increasingly used by health plans as the basis of quality improvement, network design, and financial incentives, despite concerns about data and methodological challenges.

Study Design: Evaluation of health plan administrative claims and enrollment data.

Methods: Using administrative data from 9 health plans, we analyzed results for 27 well-accepted quality measures and evaluated how many quality events (patients eligible for a measure) were available per primary care physician and how different approaches for attributing patients to physicians affect the number of quality events per physician.

Benchmarking physician performance: reliability of individual and composite measures.

Objective: To examine the reliability of quality measures to assess physician performance, which are increasingly used as the basis for quality improvement efforts, contracting decisions, and financial incentives, despite concerns about the methodological challenges.

Study Design: Evaluation of health plan administrative claims and enrollment data.

Methods: The study used administrative data from 9 health plans representing more than 11 million patients.