Publications by authors named "Rachel Groman"

Meaningful quality measurement and public reporting have the potential to facilitate targeted outcome improvement, practice-based learning, shared decision making, and effective resource utilization. Recent developments in national quality reporting programs, such as the Centers for Medicare & Medicaid Services Qualified Clinical Data Registry (QCDR) reporting option, have enhanced the ability of specialty groups to develop relevant quality measures of the care they deliver. QCDRs will complete the collection and submission of Physician Quality Reporting System (PQRS) quality measures data on behalf of individual eligible professionals.

View Article and Find Full Text PDF

Quality measurement and public reporting are intended to facilitate targeted outcome improvement, practice-based learning, shared decision making, and effective resource utilization. However, regulatory implementation has created a complex network of reporting requirements for physicians and medical practices. These include Medicare's Physician Quality Reporting System, Electronic Health Records Meaningful Use, and Value-Based Payment Modifier programs.

View Article and Find Full Text PDF

Although federal programs aimed at improving the overall value of health care are well intentioned, most remain fundamentally flawed in terms of their metrics, their methodologies, and the pace at which they are being implemented. Without a serious reevaluation of these strategies, these programs will, at best, have limited effectiveness, and, at worst, lead to critical deteriorations in patient quality, safety, and access to care.

View Article and Find Full Text PDF

Study Design: Topic review.

Objective: Describe value measurement in spine care and discuss the motivation for, methods for, and limitations of such measurement.

Summary Of Background Data: Spinal disorders are common and are an important cause of pain and disability.

View Article and Find Full Text PDF

Clinical registries have emerged in the current resource-restricted environment of modern medicine as useful and logical mechanisms for providing health care stakeholders with high-quality data related to the safety, effectiveness, and value of specific interventions. Temporal and qualitative requirements for data acquisition in the context of clinical registries have rapidly expanded as clinicians and other stakeholders increasingly recognize the central importance of this information to the intelligent transformation of health care processes. Despite the potential of more robust clinical data collection efforts to advance the science of care, certain aspects of these newer systems, particularly the prospective, longitudinal acquisition of clinical data and direct patient contact, represent areas of structural overlap between emerging quality improvement efforts and traditional models of human subjects research.

View Article and Find Full Text PDF

In an effort to rein in spending and improve patient outcomes, the US government and the private sector have adopted a number of policies over the last decade that hold health care professionals increasingly accountable for the cost and quality of the care they provide. A major driver of these efforts is the Patient Protection and Affordable Care Act of 2010 (ACA or Pub.L.

View Article and Find Full Text PDF

How have state legislatures acted to address racial and ethnic disparities in health care? This article examines trends over time in state legislation related to disparities in care and access, proposed legislation during one biennial session, and contemporary legislative attitudes and awareness of the issue. The mix of strategies adopted across the states reflects the differing ways that states understand gaps in minority health and changing strategies over time. Historically, California, Florida, and Louisiana (all states with substantial minority populations) have been the most active in dealing with minority health issues through statutes.

View Article and Find Full Text PDF

Disparities clearly exist in the health care of racial and ethnic minorities. This position paper of the American College of Physicians (ACP) provides ample evidence illustrating that minorities do not always receive the same quality of health care, do not have the same access to health care, are less represented in the health professions, and have poorer overall health status than nonminorities. The ACP finds this to be a major problem in our nation's health system that must be addressed.

View Article and Find Full Text PDF