BACKGROUNDER: AQA DATA SHARING AND AGGREGATION PILOT PROJECTS
The Ambulatory Care Quality Alliance (AQA), working with the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ), has developed a pilot project on data sharing and aggregation. Six pilot sites, soon to be announced, will collect public and private healthcare quality data to measure and report on physician practice performance in a meaningful and transparent way for consumers and purchasers of health care.
One roadblock to measuring and reporting of physician performance has been that it is conducted piecemeal. Physicians with patients covered by multiple public and private programs have their performance measured separately, often using different quality measures, for each program. A more comprehensive view of physician practice is needed, but until now no mechanism has existed to collect and aggregate data from these multiple sources.
The pilots will test approaches to aggregating and reporting physician performance data publicly. It is expected that the results of these pilots will provide a national template for performance measurement and public reporting. The results can be used for two primary purposes: first, to provide performance information to physicians that will assist them in improving the quality of care they are delivering; second, to give information to payers and consumers to assist them in determining where to seek care. In addition, the pilots will not only measure care quality, but will identify those high quality providers who are able to deliver efficient care to patients, avoiding unnecessary complications and costs.
For example, Dr. Jones is seeing 50 diabetic patients for 25 different health plans or insurers. Each insurer may have information on two or three of those patients, and cannot calculate meaningful quality of care measures with such a small number of patients. Under the pilot program, everyone involved with Dr. Jones’ diabetic patients agree to pool the information they have and report performance results that have greater scientific validity on how well Dr. Jones takes care of diabetic patients. Dr. Jones can use the results to compare his performance with other doctors and focus on how to do better. In addition, some of this information can be shared with consumers and payers to help in identifying the best healthcare providers and where they might seek their healthcare.
The sites to be selected will represent areas of the country where there is strong physician leadership and a rich history of collaboration on quality and data initiatives among multiple health plans and physician groups. The sites will have the necessary infrastructure and experience to support combining public and private data and to begin their work in real time.
The Pilot Project will be supported with funding from CMS and AHRQ. AQA plans to expand its starter set to include multiple physician specialties in Spring 2006.
The Ambulatory Care Quality Alliance (AQA) is a collaborative effort initiated in September 2004 by the American Academy of Family Physicians (AAFP), the American College of Physicians (ACP), America ’s Health Insurance Plans (AHIP), and the Agency for Healthcare Research and Quality (AHRQ). AQA’s mission is to improve health care quality and patient safety through a collaborative process in which key stakeholders agree on a strategy for measuring performance at the physician level, collecting and aggregating healthcare quality data in the least burdensome way, and reporting meaningful information to consumers, physicians and other stakeholders to inform choices and improve outcomes of care. There are currently over 125 member organizations in AQA representing physicians, consumers, employers, government, health insurance plans, and accreditation/quality improvement organizations. AQA has defined and agreed to use nationally a starter set of 26 quality of care measures that evaluate medical conditions including cancer screening, tobacco use and counseling, vaccinations, heart disease, diabetes, asthma, depression, and pre-natal screening.