ACR Quality Measures

The quality movement, or “QM,” has been gaining momentum over the last few years. Pay-for-performance, outcome measurement and similar concepts are swiftly becoming part of the healthcare landscape. The QM will impact how physicians treat patients and how physicians are reimbursed for their services.

The QM seeks to improve patient outcomes by identifying and promoting best practices ranging from use of diagnostics, medications and procedures to physician practices and hospital operations. Determining best practices includes analyzing the effectiveness of products and services; finding flaws in care-delivery systems that lead to medical errors; and measuring how physicians treat their patients – doctor by doctor, patient by patient. Once best practices are determined, professional organizations can use this information to produce treatment guidelines, and various organizations may use the practices as the foundation for pay-for-performance programs, physician rankings and other initiatives. The ACR is defining best practices for treating rheumatic diseases, and not ceding that responsibility to others less knowledgeable.

The QM promises to raise the quality of patient care overall. Establishing best practices for each rheumatic disease physicians treat will help provide the right care at the right time to each patient. Payor incentive programs, when implemented appropriately, can serve as a bar that physicians can strive to reach, to the benefit of patients. High-quality care should consistently result in more efficient care, saving costs to the health system and physician practices – over the long term.

If quality is not pursued with adequate expert input, however, a one size-fits-all system of care could be created based on 1) an oversimplification of appropriate rheumatologic treatment, and 2) short-term cost-savings. Perverse incentive programs that adhere blindly to specific medical practices could punish physicians for providing appropriate care to some patients–an untenable conflict that would damage patients’ trust. That is why the ACR is actively leading the effort to define quality care for patients with rheumatic diseases.

Broadly speaking, the ACR is working in the following areas:

Classification/Response Criteria - Classification and response criteria form the foundation for clinical studies in rheumatology. Such criteria allow investigators conducting trials to consistently define a study population and to know when clinical improvement has occurred.	Quality of Care - The ACR aims to develop tools and processes to help rheumatologist implement Quality measures in their practices as well as the measures themselves.	Rheumatology Training- The ACR Rheumatology Fellowship Core Curriculum Outline addresses quality of care in a way that no previous curriculum outline has done. The ACR wants to prepare rheumatology fellows for work in an environment where evaluating and reporting on quality of medical care is an integral part of their practices.	Resource Library - This library contains tools more information about Quality. (FAQ, Glossary, Collaborative Activities, Quality-Related Links and Recommended Reading, Practice View)
Practice Guidelines - Practice Guidelines are evidence-based recommendations that bring together the scientific evidence available at a certain point in time in a manner that outlines the options available.	Professional Education	Government Affairs - ACR’s Government Affairs Committee is working with both Congress and CMS during the development and implementation of QPIs. GAC is also actively engaging with other organizations that have a vested interest in the quality movement to monitor and respond to quality-related legislation.	Physician Quality Reporting Initiative – A summary of the PQRI for ACR members and their practice management staff. This summary includes links to the appropriate CMS pages.

Current RFPs

There are currently two RFPs available for comments:

• JIA Guidelines – LOI due May 12

• Criteria projects - LOI due May 15

Member Survey Results

Results from the summer 2006 membership survey on quality issues are summarized here.

Committees

The ACR has formed the Quality of Care Committee and the Quality Leadership Council to coordinate the quality-related efforts across the college and communicate to membership about these initiatives.

• QoC - The Quality of Care Committee was formed in summer 2004, to achieve its quality related objectives

• QLC - The Quality Leadership Council helps define the overall strategy of the ACR’s quality initiatives and integrates the quality-related work of the ACR committees.

For More Information

For more information about any of the above programs, contact ACR staff: Amy Miller at , or Amy Beith Miller at . Both can be reached at (404) 633-3777.