Survey: Doctors Wary of Quality Metrics

About half of the nation’s primary care doctors expressed concern about quality-of-care metrics commonly used by accountable care organizations, according to the 2015 National Survey of Primary Care Providers released last week by the Kaiser Family Foundation and the Commonwealth Fund.

In that survey, almost half of all primary care physicians surveyed (47% of them) also said that recent trends in health care are leading them to consider an earlier retirement.

According to KFF officials, the survey reflects a continuing 20-year pattern of physician dissatisfaction with market trends in health care.

That dissatisfaction extends to quality metrics and the financial penalties for not meeting those metrics. Roughly 50% of surveyed physicians said those provider performance metrics have a negative effect on patient care. About 22% said the practice would have a positive effect on patient care.

About 52% said financial penalties for hospital readmissions and other care quality issues actually hurt patient care, and just 12% thought they’d have a positive effect.  

“Overall, providers are more negative about the increased reliance on quality metrics to assess their performance and about financial penalties” associated with quality metrics, the survey authors concluded.

The survey also looked at a number of other primary care physician attitudes and opinions, particularly toward the new shifts toward medical homes, ACOs and more health information technology use:

  • Half of the physicians surveyed — as well as about two-thirds of the nurse practitioners and physician assistants surveyed — said more advanced health information technology has improved quality of care for patients;
  • Most physicians surveyed (about 60%) didn’t have an opinion about the effect of ACOs on patient quality, but of the ones who did have an opinion, about twice as many had a negative opinion, roughly 26% with a negative view and about 14% with a positive view; and
  • The view of medical homes was more positive, with about a third of respondents saying medical homes have a positive effect on patient care, and just 14% who see negative effects on care.

“The survey results indicate that primary care providers’ views of many of these new [health care delivery and finance reform] models are more negative than positive,” according to an issue brief from KFF and the Commonwealth Fund. “There are exceptions: health information technology gets mostly positive views and medical homes receive mixed opinions with a positive tilt.”

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