Evaluate Performance with Physician Quality Measures
The Only Constant Is Change
In addition to the shift toward
value-based reimbursement, a variety of market forces are causing rapid changes within the healthcare industry. These include:
- Convergence and integration
- As employers, health plans, and providers come together, the value of contracts is growing, but the number of potential customers is shrinking
- Likelihood of disruptive entry
- Urgent care and walk-in pharmacy clinics, along with wearable and other internet-enabled health technologies, are changing healthcare at an astonishing rate
- Uncertainty in the marketplace
- The implications of the Affordable Care Act and the transition to ICD-10 will continue to reveal themselves in the coming years
As the industry moves to place a greater emphasis on value to the patient, the physician quality measures used to evaluate practitioner engagement and performance are evolving in kind.
6 Physician Quality Measures of OPPE
The goal of Ongoing Practitioner Performance Evaluations (OPPE) is to provide data on performance for all practitioners in a timely, ongoing manner in order to identify issues and ultimately improve performance. OPPE stresses 6 core competencies:
- Patient Care
- Provide compassionate, appropriate, and effective care
- Promote health, prevention and treatment of disease, as well as end-of-life management
- Medical and clinical knowledge
- Demonstrate knowledge of established and evolving biomedical, clinical, and social sciences
- Apply this knowledge to patient care and the education of others
- Practice-based learning and improvement
- Use scientific evidence and methods to investigate, evaluate, and improve patient care practices.
- Interpersonal and communication skills
- Display interpersonal and communication skills that establish and maintain professional relationships with patients, families, and other members of healthcare teams
- Reflect a commitment to continuous professional development and ethical practice, an understanding and sensitivity to diversity, and a responsible attitude toward patients, medicine, and society
- Systems-based practice
- Understand the contexts and systems in which care is provided and apply this knowledge to improve and optimize care
Best Practices for a Physician-Aligned OPPE Process
All physicians within a network should be included in OPPE, not just those with identified performance issues. A clearly defined process should address:
- Validity: Do physician quality measures measure what they’re supposed to?
Example: Does a secondary diagnosis that wasn’t present on admission measure complications?
- Accuracy: Does the measure correspond to the true value?
Example: Does a count of inpatient activity by attending physicians undercount total activities for surgeons?
- Reliability: Will it provide the same result if it is re-counted?
Example: Are health information coding- or case review-dependent measures reproducible?
- Accessibility: Is the information formatted in a usable design?
Example: Is there a dashboard for quick viewing plus the ability to do detailed analysis if needed?
- Availability: Are physician quality measures refreshed frequently enough?
Example: Can physicians genuinely use these measures to change their behaviors in real time?
Find out how
McKesson Practitioner Evaluation™ can streamline and accelerate your physician evaluation efforts.
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Healthcare Cost Accounting