Question

How has the American Medical Association (AMA) shaped current performance improvement or quality incentives?

Answer 1

The American Medical Association (“AMA”) has developed evidence based measures of doctors’ performance in collaboration with medical specialties and the federal Centres for Medicare and Medicaid Services groups.
The AMA recommended the Physician Consortium for Performance Improvement to develop by consensus the evidence based measures of doctors’ performance in multiple clinical areas. The consortium includes members from various national medical specialty and state medical societies, the Agency for Healthcare Research and Quality and the Centres for Medicare and Medicaid Services, administering the Medicare health insurance programme.
Medicare payments to doctors do not currently take into account the quality of care that doctors provide. The administration has promoted “pay for performance” standards for healthcare providers to publicise how well they are doing and to link their performance to Medicare payments.
The AMA has developed a common set of performance measures for the doctors to comply with specific standards set by health insurance companies, health plans, and government agencies; the consortium has developed numerous measures covering the conditions; including adult diabetes, asthma, chronic obstructive pulmonary disease, chronic stable coronary artery disease, community acquired bacterial pneumonia, heart failure, hypertension, major depressive disorder, osteoarthritis, prenatal testing, and preventive care and screening. The association has made the doctors’ groups to develop the best method for doctors to report quality data to the centres. They also work with the centres and with congressional committees to implement additional reforms to tackle payment and quality objectives.
Each doctor voluntarily reports to the centres on between three and five quality measures. Doctors who do so “receive an additional quality update to offset administrative costs”. The doctors’ groups have developed performance measures for most clinical services paid for by Medicare.