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Measuring Quality in Oncology – Challenges and Opportunities

Variations in the quality of cancer care are well documented. A key element of quality monitoring is standardized measures of care. Quality measures may include both process measures and outcome measures. Process measurement is only one aspect of assessing the quality of cancer care; measuring outcomes and providing the appropriate structure for care are also important. Measuring outcomes such as overall survival can be expensive and complicated by existing co-morbidities and may take too long to measure to truly affect delivery of care. Adherence to process measures is often used as a proxy for long-term survival. The implicit assumption is that adherence to good processes will predict good long-term outcomes. Quality measures can be used for both self-assessment and external review of the quality of care.

Payers and purchasers of health care are often users of standardized measures as they seek to ensure their beneficiaries are receiving high quality cancer care for a reasonable cost. Both public and private payers are placing a greater emphasis on quality, often times by linking reimbursement to quality. In response to this growing trend to prove value, payers, professional organizations, and provider groups have begun to create metrics based on evidence from research literature and guidelines. Quality measures that quantify the patient experience are also becoming increasingly popular, including but not limited to length of time away from work or family, speed and completeness of recovery, avoidance of toxicity and financial hardship are important to patients, but may or may not be used by providers or payers in their assessment of quality.

In the summer of 2013, NCCN will host an invitation-only NCCN Policy Summit that will serve as a forum for stakeholders to discuss the challenges and opportunities for measuring quality care in oncology. We will examine the current efforts to develop quality measures and measure quality, discuss the value of quality measures and if we have seen improvement in patient care because of quality measures, and consider the impact of new care/payment models on quality cancer care.

 

 

 

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