Center for Medicaid and Medicare Services quality measures might not measure or capture the actual care patients receive, according to a new Government Accountability Office (GAO) report.
The GAO studied how the agency decides what quality measures to develop and use. It also evaluated how CMS monitors its funding for quality measurement activities.
The GAO report stated that CMS doesn’t have processes to ensure that the indicators actually measure what the agency says it cares about in its strategic objectives. The GAO also found that the CMS carries over large sums of unused funds each year for activities related to quality measurement and that the CMS fails to keep track of all its quality-measurement funding.
The report recommends that CMS should create standard practices to assess the measures that it’s considering to emphasize and align them with strategic quality objectives. It also recommended that CMS improve its tracking of progress in achieving its goals by developing and using performance metrics. The GAO also said that the CMS should keep more comprehensive and thorough information on its quality funding.
In response, the Department of Health and Human Services (HHS) stated they agree with the GAO’s recommendations.
CMS’ decisions about which quality measures to use or whether to create new ones have a massive impact on the healthcare industry as private payers can use Medicare’s quality measures. Its choices affect both the quality of care that patients receive and how much providers get paid, as well as whether they’re enrolled in Medicare or not.
Read the GAO Report here.