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Published 7/1/2014
Mary Ann Porucznik

AAOS Hosts Performance Measures Development Summit

New committee faces challenge of orthopaedic-specific measures

For more than a decade, the AAOS has been involved in efforts to provide practical tools to members to improve the quality of care they provide to their patients. Those efforts are now moving into high gear, with the creation of a new Performance Measures Committee under the Council on Research and Quality (CORQ), and the announcement of a Board of Specialty Societies (BOS) Performance Measures Summit, which will be held July 19, in Rosemont, Ill.

“Developing orthopaedic-specific performance measures is the next step in improving value in health care,” said Kevin J. Bozic, MD, MBA, CORQ chair. Performance measures are based on clinical practice guidelines, which provide the evidence to support high value healthcare delivery. They are selective, focused, measurable, and actionable. Over the next 4 years, the AAOS hopes to complete a minimum of six performance measure sets, along with implementation and validation tools.

“Performance measures will play an important role in public reporting, payment policies, credentialing, and continuous quality improvement,” noted Dr. Bozic. “The AAOS will have an important leadership role in defining quality and developing performance measures for musculoskeletal care.

“Our performance measures initiative provides us, as orthopaedic surgeons, with the opportunity to control our own destiny,” he continued. “We know our performance is being measured by payers, public reporting agencies, purchasers, and even credentialing bodies. But really, those groups are looking to the profession to define what is important and how to measure it.

“Until now, orthopaedic surgeons have had little input into defining quality in musculoskeletal care, so many of the measures that are being used may not actually help improve the quality of care we provide,” said Dr. Bozic. “This gives us an opportunity to say, ‘Here’s what we think is important to measure and here’s how we propose to measure it.’”

The most recent example of orthopaedic efforts in developing performance measures focused on total knee replacement and involved a joint effort by The Knee Society, the American Association of Hip and Knee Surgeons (AAHKS), and the AAOS. The measure set has been accepted by the Centers for Medicare & Medicaid Services (CMS) as part of its value-based purchasing program.

According to David A. Halsey, MD, BOS chair-elect, who led the effort, this was one of the first sets of orthopaedic-specific performance measures accepted by CMS and the first effort led by orthopaedic societies. A multidisciplinary group developed the measures through the American Medical Association’s Physicians Consortium for Performance Improvement.

The BOS Performance Measures Summit will provide attendees with an overview of the criteria for evaluating, selecting, and prioritizing performance measure topics and review the AAOS timeline for developing performance measures. It will also help define next steps in identifying outcomes measures of importance for individual specialty societies.

Orthopaedic specialty societies—including the North American Spine Society, the Orthopaedic Trauma Association, and AAHKS—will provide updates on their own performance measure efforts, covering measures developed, processes in place, lessons learned, and future plans.

“This summit is an opportunity for the early adopters of quality measurement and development to showcase what they’ve done and enable other specialty societies to learn from their experiences,” said Dr. Halsey.

Mary Ann Porucznik is managing editor of AAOS Now. She can be reached at porucznik@aaos.org

Measuring Performance
Under the direction of Warren Dunn, MD, MPH, the new AAOS Performance Measures Committee is charged with overseeing the development of orthopaedic performance measures and ensuring that appropriate processes for developing these measures are followed. The committee will also develop a process and criteria for assessing orthopaedic and musculoskeletal health-related performance measures developed by other organizations.

Working with member societies of the Board of Specialty Societies (BOS), the committee will establish processes and procedures for creating specialty-specific performance measures and devise a plan for collecting and measuring performance and quality data. It will also work with external stakeholder groups, including payers, purchasers, policymakers, patient advocacy groups, and healthcare provider rating agencies to determine priority topic areas for orthopaedic performance measures.

In addition, the committee will also investigate and attempt to influence the use of orthopaedic performance measures in emerging value-based payment strategies and public reporting of provider performance.

Committee members include George F. Muschler, MD, vice-chair; William Timothy Brox, MD; Joseph P. DeAngelis, MD; and Jill E. Larson, MD, members-at-large; David R. Chandler, MD, and Khaled J. Saleh, MD, MSc, FRCSC, FACS, BOS representatives; and Douglas K. Dew, MD, MBA, and Stephen M. McCollam, MD, Board of Councilor representatives.

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