The Abysmal State of Transparency in Quality of Care

Submitted by hci3-usr on Saturday, April 2, 2016 - 03:42

Newtown, CT – April 2, 2016

This week’s Consumer Reports and our report on Diabetes costs in the U.S. reminds us of the abysmal state of transparency in quality of care – Several regional efforts published a handful of measures in a special supplement to Consumer Reports. These are the same regions that were highlighted in our Quality Transparency Report Card in November 2015, and while some of them stand out for the validity of the quality measures they publish, many simply show the same old warmed up slop that is, at best, misleading. Our friends at MN Community Measurement have long been at the forefront of the bold measurement of patient outcomes and what makes them stand out now as they did a decade ago, is that they stand alone. States like Massachusetts that are often heralded to be at the forefront are content to publish three weak process measures that supposedly differentiate high quality PCPs from lower quality ones. What a bad joke that is. But worse, it perpetuates the notion that three measly process measures can actually indicate good quality care, when, in fact, those measures are not at all indicative of how well these physicians produce quality outcomes, in particular for those who need it most: patients with chronic conditions like Diabetes. Our report, published earlier this week, shows that there are billions of dollars across the country – including millions in Massachusetts – that are wasted on avoidable complications and low value services, all the while failing to plug underuse.

What this means to youOur friends at CPR have released an update on the required specifications for transparency tools, and emphasize the critical importance for these tools to incorporate measures that are important to employees and their family members. These measures include those that were highlighted this week by MN, but don’t include the paltry measures released with great fanfare by many others. Consumers are being misled across the country either by not having access to any quality measures, as we reported in November, or by measures that simply fail to identify who is really better at managing specific conditions. In the meantime, patients continue to receive substandard care and our analyses show this repeatedly, everywhere, except in places like MN where accountability isn’t simply a political slogan, but deeply engrained in the practice of medicine. Consumer Reports, in a featured article, points out that there are many physicians that continue to harm patients, shielded by the failure of state medical societies to exert discipline. While that’s true and should stop, this type of sensationalism isn’t helpful because it hides the real problem, which is the general failure to measure patient outcomes and broadly report them. And as we said a few weeks ago, that’s unlikely to change any time soon from the top because physician lobbies have usurped the measurement endorsement process. And so it’s time to wake up. Employers who are spending hundreds of billions of dollars a year continue to pour good money after bad, and not just in the management of diabetes, but of every other condition and illness. Unless they heed the advice of CPR and force through meaningful transparency, the slop fed to the masses this week by Consumer Reports will continue to pass as the finest marrow of quality, billions more will be wasted and, more importantly, patients will continue to be harmed, not by the few who should be banned from the practice of medicine, but by the many whose outcomes of care are never measured.


Francois Sig