Urologists, not feds, must develop quality measures

April 1, 2005

If we do not develop our own performance measures, someone else will do it for us.

Over the past 5 years, a number of organizations such as the Leapfrog Group have stated that the "quality" of medicine leaves much to be desired. The Institute of Medicine's statement several years ago (extrapolated from data from a handful hospitals) that between 48,000 and 96,000 patients in the United States die from medical errors per year made headlines and caused a stir.

The current hot medical topic in Washington and the private insurance industry is pay for performance, also known as P4P. Simply stated, Medicare has proposed paying providers more if they meet certain "quality measures."

In February, I had the honor to be asked to testify before the House Ways and Means Subcommittee on Health on behalf of the AUA and 12 other specialties representing over 200,000 specialty physicians. Some of the points I made to the committee were:

So what is P4P in a urology practice? Like other specialties, AUA has established a workgroup to investigate and consider what are realistic and appropriate quality performance measures for a urologist. This might be something as simple as demonstrating that a urologist adheres to published AUA guidelines, but how to report this to CMS remains unclear.

I cannot tell you at this time what this will ultimately look like. But I can tell you that if we do not develop our own performance measures, someone else will do it for us.