How well does Medicare measure quality? Not very well, especially across different treatment settings. According to a RAND report:
“Only 10 clinical conditions are addressed by reporting programs for more than one setting. Three clinical conditions are included in programs for three settings: (1) acute myocardial infarction, (2) perioperative/surgical care, and (3) urinary incontinence. Seven conditions are included in programs for two settings: (1) back pain, (2) community acquired pneumonia, (3) depression, (4) end stage renal disease, (5) heart failure, (6) pain, and (7) prevention.”
By not tracking quality measures across providers or treatment settings, physician have less of an incentive to maintain quality across the patient’s full continuum of care.