- General internists, family physicians, cardiologists, and orthopedists spend more than $15.4 billion annually to report on healthcare quality measures set by payers, according to a report from Health Affairs.
Annually, these four types of practices have spent an average of 785 hours per physician to report on quality measures. The time spent by physicians and staff on these tasks equates to an average cost of $40,069 per physician per year, the report said.
“The cost to physician practices of dealing with quality measures is high and rising,” researchers said. “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.”
Physicians and staff spent 15.1 hours per physician per week to handle external healthcare quality measures. This equates to 785.2 hours per year. The average physicians spent 2.6 hours per week dealing with quality measures. In this amount of time, physicians could have cared for nine additional patients, the researchers pointed out. Other staff members spent 12.5 hours per physician per week taking care of quality measures. Licensed practical nurses and medical assistants specifically spent 6.6 hours per physician per week handling quality measures.
Unfortunately, dealing with these measures is sometimes an inconvenience for physicians and staff. It can be difficult for them to fully understand the measures, provide performance data and understand performance reports from payers.
Almost half of participants stated it was a burden to deal with measures that were “similar but not identical to each other.” Only twenty seven percent felt that the current measures were “moderately or strongly representative” of the quality of care.
According to the report, staff spend a lot of time entering information into the medical record “only for the purpose of reporting for quality measures and external entities,” the researchers said. Licensed practical nurses and medical assistants specifically spent 6.1 hours per physician per week entering information. Physicians, on average, spent 2.3 hours a week doing this task as well.
Primary care physicians spent 3.9 hours per week dealing with quality measures, compared to cardiologists who spent 1.7 hours. Orthopedists spent 1.1 hours per week dealing with quality measures, while physicians in multispecialty groups spent 3 hours. The researchers pointed out that time spent did not vary much by practice size.
“The number of quality measures directed at US healthcare providers by external entities such as Medicare, Medicaid, and private health insurance plans has increased rapidly during the past decade,” the study said. These measures are used to provide publicly reported information for patients. They are also a basis for financial pay-for-performance incentives to physicians.
At the moment, state and regional agencies use 1,367 measures of provider quality. Only 20 percent of these measures are “used by more than one state or regional program”.
A majority of practices spent more efforts dealing with external quality measures than they did three years ago (81 percent). “Between 70.9 percent (orthopedics) and 91.7 percent (primary care) of practices expanded efforts dealing with external quality measures,” the report said.
Although quality reporting is not a simple task for physicians and staff, fixing this system would be very difficult, researchers said. There are many obstacles, such as a lack of interoperability across EHRs and a lack of EHR functionalities to facilitate obtaining data for quality measures.
“The movement toward accountable care organizations, the federal Sustainable Growth Rate fix legislation, and the private-sector Catalyst for Payment Reform coalition will further emphasize measurement of physician performance,” the report said.
The Centers for Medicare and Medicaid Services (CMS) recently updated the 2016 electronic clinical quality measures (eCQMs) for eligible hospitals and healthcare professionals for the 2017 reporting period and announced 29 new quality measures for hospitals and 64 measures for eligible professionals for use within the EHR Incentive Programs.
“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 study concluded.
Making timely improvements will be difficult, but the researchers are encouraged by many of the industry’s efforts to streamline the quality reporting process. The authors hope that the CMS and other healthcare leaders continue to make their efforts a top priority.