Quality Spine Care: Healthcare Systems, Quality Reporting, and Risk Adjustment

 

Quality measurement and quality reporting are ever growing aspects of the healthcare environment. Quality assessment is valuable to all healthcare stakeholders:  patients, physicians, facilities, and payers. Patients are drawn to facilities that provide high value care; public reporting systems and grading systems for hospitals offer one opinion with regard to “high quality care.”  Most physicians email inboxes are inundated with offers of recognition for being a “Top Doc” for a nominal fee.  Some payers offer incentives to patients who chose to be treated at “Centers of Excellence” or similar facilities; the definition of “Excellence” may be unclear.  

There is little consensus on how to measure quality, how to incorporate patient and procedure factors and achieve accurate risk adjustment, and how to define value of care.  Regardless of these challenges, regulatory efforts in the US, as well as numerous international efforts, make quality assessment and quality reporting an important part of physician behaviour.   

Physician and facility reimbursement for procedures are often tied to quality metrics. Spine procedures are costly, elective, and are a focus of many payer-based programs.  Hence, spine care is often a focus of quality reporting efforts.  This text summarizes the state of the art with regard to quality measurement, reporting, and value assessment in spine care.  We will review quality reporting in the US and internationally.   Chapters will outline how quality improvement efforts have achieved success in hospital systems.  The reader will be provided with insights in how to achieve success incorporating quality metrics into spine care.

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