Article Highlights Need to Fully Measure the Value ID Specialists Bring to Patient Care

As health care shifts from reimbursement based on numbers of patients seen or procedures performed to reimbursement based on quality of care, the infectious diseases (ID) specialty will need to develop measures that accurately reflect the complex, expert care that ID physicians provide. A recent article in Clinical Infectious Diseases outlines the growing importance of quality measures, how they relate to ID, and how metrics specific to the field might be crafted.

“In a value-based reimbursement system, physicians need to prove their value, and do so objectively,” said article lead author Joshua C. Eby, MD, of the University of Virginia. Upcoming changes will increasingly tie a portion of health care providers’ Medicare payments to the reporting of established quality measures, but few ID-specific benchmarks have been developed and approved for use so far. “There are very few measures that are really focused on what ID doctors do,” Dr. Eby said.

Approved quality measures currently available for reporting through Medicare’s new Merit-Based Incentive Payment System (MIPS), such as those related to antibiotic use or common, routine infections, are often more applicable to care provided by non-specialists, the article notes. They do not accurately quantify the value that ID physicians provide in more complex, difficult cases, where consultation with an ID specialist can significantly improve patient outcomes, which several studies have shown. Without adequate metrics or benchmarks, payers, health care institutions, and medical provider groups may struggle to fully assess the value of ID specialty care under new payment models.

The article describes considerations for the development of quality measures for the ID specialty and approaches taken by providers in other specialties, such as rheumatology, to create a clinical data registry as an alternative to MIPS reporting. Ultimately, the authors note, an effective mix of nationally recognized ID-related measures will help move the specialty forward by promoting improved patient care, demonstrating ID specialists’ contributions to care, and allowing institutions and payers to properly value the important services that ID physicians provide.

“There’s a lot of work to be done,” Dr. Eby said. “This article just sets the stage for how important quality measures are and how challenging they can be to create. The real work will be in making good quality measures for ID specialists to use.”

The article, “How Do You Measure Up: Quality Measurement for Improving Patient Care and Establishing the Value of Infectious Diseases Specialists,” is available online.