AMAP issues criteria for doc performance systems
Quality standards move a step closer to reality
The American Medical Accreditation Program (AMAP) moved closer toward quality improvement standards with the release of criteria for physician performance measurement systems.
Eventually, AMAP will mirror the ORYX program of the Joint Commission on Accreditation of Healthcare Organizations, in which hospitals and health systems can choose an approved vendor for monitoring outcomes. Yet with few such systems available for physicians, AMAP officials acknowledge that physician measurement is still in its formative stages.
"What we’re trying to do is to accelerate the development of good systems," says Terry Hammons, MD, MS, assistant vice president for quality and managed care of the American Medical Association in Chicago, which sponsors AMAP.
AMAP will require systems to protect patient confidentiality, to enable physicians to communication with their peers about measurement results, to provide assistance in understanding the data feedback, and to incorporate some form of risk adjustment.
The systems also will focus on the conditions and patient populations that will form the core measures, says Hammons. Diabetes, asthma, and congestive heart failure will be among the first measurement areas, he says.
AMAP is relying on specialty societies for much of the development work on the measures, and those organizations may also be the source of performance systems. For example, the Society of Thoracic Surgeons, the American Academy of Orthopedic Surgeons, and American Academy of Ophthalmologists have existing, well-respected systems.
AMAP eventually will require physicians to be a part of such a system. But specific scores on performance measures won’t be released to the public.
The program is designed for quality improvement, stresses Hammons. For example, while the National Committee for Quality Assurance in Washington, DC, will release rates showing what percentage of diabetic populations of health plans meet blood glucose goals, AMAP would tell physicians how many patients were in various ranges below and above that goal. "[Physicians] want more extensive information," he says.
AMAP promises to reduce burden
AMAP is also touting its accreditation program as a way to reduce the burden of credentialing, site review, and medical record review for physicians. Physicians in Utah will have a chance to find out if AMAP can deliver on that promise.
Altius Health Plans of Salt Lake City, which was formed last fall from the purchase of a portion of PacifiCare, announced it will use AMAP for its credentialing, site review, and medical record review and will require physicians to achieve AMAP accreditation.
Altius also values AMAP’s quality and measurement goals, says Dennis Harston, MD, MBA, vice president of medical affairs. "We want to be the quality option in our marketing area," he says. "We think this is a perfect marriage of quality and information."
Physicians expressed some concerns about whether AMAP would issue a scoring system. But Harston says as physicians become educated about AMAP, they will appreciate its goal of reducing duplication and paperwork. "They want to see a single credentialing process rather than eight, nine, or 10 [from various health plans]," he says.
Altius has a network of about 2,000 physicians who provide care for 95,000 covered lives. Harston says he expects competitors to move toward AMAP accreditation, as well, which would broaden the benefits to physicians.
NYLCare in New Jersey was the first health plan to sign on with AMAP, but that relationship ended when the health plan was purchased by Aetna.
"[The Altius arrangement] gives us an opportunity to show the value that AMAP has for a health plan," says Hammons. "We have to get a critical mass of people participating in order to show what it can do."
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