Less than 40% of quality metrics used to assess physician performance are valid, according to a study published online April 18 in the New England Journal of Medicine.
Researchers from the Hospital for Special Surgery (HSS) in New York City found that 37% of physician performance measures met a list of criteria for validity formulated by the American College of Physicians (ACP). Among the rest, 35% were deemed invalid, and the validity of the remaining 28% was uncertain.
Physicians in the U.S. are now tracked on more than 2,500 performance measures, wrote the team led by Dr. Catherine MacLean, PhD. The measures cost about $40,000 annually per physician to meet, according to the group.
MacLean and colleagues evaluated 86 general internal medicine performance measures that are part of Medicare's Merit-Based Incentive Payment System/Quality Payment Program, an initiative that links physician performance and patient outcomes to reimbursement. The group used the ACP's five-item checklist to test the validity of the measures: The factors were importance, appropriateness, strength of clinical evidence, feasibility of implementation, and applicability.
Thirty of the measures (35%) failed the test; of those, 19 lacked sufficient clinical evidence to warrant implementation, the researchers wrote.
"The point of the paper isn't that we don't support quality measures," MacLean said in a statement released by the HSS. "We've had careers in developing them. The problem is that bad quality measures can be harmful. Additionally, they are a waste of time; they're frustrating, and they're a waste of money. It's gotten to the point where it's almost measures for measurement's sake."
