AMAP-JCAHO-NCQA co-op will ease data collection

While the American Medical Accreditation Program (AMAP), created by the Ameri can Medical Association (AMA) in Chicago, is beginning to define quality standards for individual physicians, last January it and the nation’s other two leading health care quality oversight groups — the Joint Commission on Accreditation of Health care Organizations, which evaluates hospitals and other health care facilities and networks, and the National Committee for Quality Assurance (NCQA), the main accreditor of health plans — rolled out a plan to coordinate quality measures.

Performance measures currently vary from one type of organization to the next, but there is overlap. For example, patient satisfaction, immunization rates, and cervical cancer screening rates are used to assess physicians, facilities, and plans alike. Other broadly applied measures include cesarean section rates, mammography rates, measures of accessibility of care, cost measures, and utilization rates.

Last year, the three organizations established a 15-member Performance Measurement Coordi nating Council (PMCC) to ensure that measurement-driven assessment processes are efficient, consistent, and useful for the many parties that rely on them to help make decisions about health care. (A list of Council members can be found on the Web at www.ncqa. org, www. jcaho.org, or www.ama-assn.org/amap.) Ostensibly, colla boration among the organizations is projected to significantly reduce the cost and effort required for collecting performance data.

AMAP, the Joint Commission, and NCQA currently define performance measurement at their respective levels of the health care system — the physician, the hospital or network, and the health plan. Consequently, each organization supports its own measure development efforts, often at great expense, and often drawing on the same pool of intellectual talent as the other organizations. Inte gration of development efforts not only streamlines the process and saves money, but also produces better, more broadly applicable measures that relate to each other and describe expectations for accountability at different levels of the system.

A common criticism of performance measurement activities is that costs for data collection and reporting can be high. The PMCC’s efforts will help to reduce those costs by:

• coordinating identification or development of universal measures to assess physician, facility, or health plan performance in the same ways;

• standardizing data requirements for different measurement systems;

• devising means of coordinating measurement activities among physicians, organizational providers, facilities, and health plans;

• establishing more efficient verification and data quality assurance systems;

• developing guidelines for the appropriate use of performance data.

The PMCC also will address issues such as standardizing risk-adjustment techniques, a key issue for measuring performance at the physician, facility, and health plan levels.