The Institute of Medicine (IOM) drew the nation’s and Congress’s attention to quality improvement in health care when it published the landmark reports To Err Is Human344 and Crossing the Quality Chasm345 in 2001. Since that time, national quality improvement organizations and individuals dedicated to improving the standards of patient care have continued to envision quality targets and pathways for reaching them. The climate resulting from the IOM’s Quality Chasm reports, and subsequent efforts to improve quality through performance metrics and programs linking reimbursement to performance, led the ACCP to authorize the Quality Improvement Committee (QIC). The QIC is charged with assessing, commenting and voting on, and influencing the development and endorsement of performance measures that pertain to pulmonary, critical care, and sleep medicine, so that chest physicians’ interests can be represented in national efforts to improve healthcare quality and performance.
The Centers for Medicare and Medicaid Services (CMS) Physician Quality Reporting Initiative (PQRI), allows for a financial incentive to be paid to eligible professionals who successfully report on claims related to an approved set of quality measures on an annual basis. These providers may earn a bonus payment, subject to a cap, currently 1.5% of total allowed charges for covered Medicare physician fee schedule services. Present thinking is that a form of this value-based purchasing program will eventually be instituted to reimburse providers based on their adherence to approved performance measures. Private insurers are also incorporating performance measures into their plans, with reimbursement subject to compliance with approved or endorsed performance measures.
The National Quality Forum (NQF) is a not-for-profit membership-based public-private partnership proposed by a presidential advisory committee to develop and implement a national strategy for health care quality measurement and reporting. NQF has endorsed performance measures for tobacco dependence screening, treatment, and counseling (see NQF Web site for the most recent measures).
Not all quality indicators or performance measures receive the endorsement of the NQF, and several of these have been implemented in local institutions or community settings. The National Quality Measures Clearinghouse (NQMC) is the most complete resource for performance measures. Readers are encouraged to check this dynamic site regularly for updated performance measures related to tobacco cessation.
The Physician Consortium for Performance Improvement (PCPI) is one of the major developers of performance measures. Their Web site is a wonderful resource for tools to assist physicians with the implementation of all performance measures, including those related to tobacco treatment.