Consensus reached on ambulatory care measures.(Practice Trends)

Taking a crucial first step in an effort to make pay for performance work for office-based physicians, a coalition of physician groups, insurers, and the federal government has endorsed a set of 26 clinical performance measures for the ambulatory care setting.

The coalition--the Ambulatory care Quality Alliance (AQA)--was formed last year by the American Academy of Family Physicians, the American College of Physicians, America's Health Insurance Plans, and the Agency for Healthcare Research and Quality.

The starter set of 26 measures focuses on prevention, chronic care, and the overuse and misuse of certain treatments. The set could be implemented as early as next year

A unified set of measures will be valuable, said Paul Gluck, M.D., chair of the quality improvement and patient safety committee of the American College of Obstetricians and Gynecologists, but the key is choosing the right ones.

Quality targets should be based on whether they can be measured, whether they will improve care, and whether the physicians can influence the target, said Dr. Gluck of the University of Miami.

AQA's starter set of measures was assembled from existing measures developed by either the Physician Consortium for Performance Improvement or the National Committee for Quality Assurance. Most of the measures are now under review by the National Quality Forum.

AQA compiled the set in part to reduce the administrative burden on physicians, said John Tooker, M.D., CEO and executive vice president of the American College of Physicians. Most physicians deal with multiple health plans, and having a single set of uniform measures used across all plans would lessen the hassle factor for physicians, he said.