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Abstract Number: 2051

Standardized Data Collection Supports Reliable Reporting of Rheumatoid Arthritis (RA) Measures for the Medicare Physicians’ Quality Reporting System

J. Timothy Harrington1, George Reed2, Katherine C. Saunders3, Lisa Lemire4, Aimee Whitworth4, Jeffrey D. Greenberg5 and Joel M. Kremer6, 1Joiner Associates LLC, Madison, WI, 2Division of Behavioral and Preventive Medicine, University of Massachusetts Medical School, Worcester, MA, 3Corrona, LLC., Southborough, MA, 4CORRONA, Inc., Southborough, MA, 5New York Hospital for Joint Disease, New York, NY, 6Albany Medical College and The Center for Rheumatology, Albany, NY

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: quality of care and rheumatoid arthritis (RA)

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Session Information

Title: Quality Measures and Innovations in Practice Management and Care Delivery

Session Type: Abstract Submissions (ACR)

Background/Purpose:

The Medicare Physicians’ Quality Reporting System (PQRS) program encourages physicians to measure and report clinical processes and disease outcomes that correlate with quality care, including an Rheumtoid Arthritis (RA) measures bundle.  Physicians typically review patients’ records for a single visit to determine how many measures are documented and met, or not.  An alternative approach is to proactively collect standardized clinical data at each visit that includes that required for documenting each measure.

Methods:

The Consortium of Rheumatology Researchers of North America (CORRONA) registry collects standardized clinical data from RA patients and their rheumatologists during routine office visits, including the data for each RA measure. As examples, patients complete a modified Health Assessment Questionnaire (mHAQ)(Measure 178) and investigators complete a 0 – 10 segmented Physician Global Assessment (Measure 177). All enrolled patients have completed informed consent for the CORRONA registry.  In 2011, at least 1 visit report was submitted for 15,615 unique RA patients by 213 CORRONA investigators.   Measures evaluated included Measure 108: Disease Modifying Anti-rheumatic Drug (DMARD) Therapy is or is not prescribed, and if not, why not?; Measure 176: For patients started on a first biologic, is a TB skin test or Quantiferon assay documented during the 6 months prior to starting the treatment, or not; Measure 177: Is RA disease activity documented as controlled,-low, moderate or high; Measure 178:  Has functional status been assessed during the previous 12 months?; Measure 179:  Is RA prognosis assessed and documented as good, poor, or undetermined?; Measure 180:  Is the patient on =/> 10 mg of prednisone for greater than 6 months or not, and if so, is a management plan documented to either increase other treatments and/or taper the prednisone dose.  The most recent 2011 report for each patient was studied.

Results:

The number (N) and percent (%) of visit reports meeting or not meeting each measure are shown, as are the number of reports meeting exclusion criteria for each measure, such as patients with controlled disease off DMARD treatment being excluded for Measure 108 (N = 521), and those who were not starting a first biologic being excluded from Measure 176.

Conclusion:

Collecting standardized data assures reliable measures reporting.  The percents of Performance Met were high, except for Tb testing before DMARD initiation. 

 

Measure Number

Total Sample

N

Performance Exclusion

n (% of N)

Total Met+UnMet

M

Performance Met

n (% of M)

Performance Not Met

n (% of M)

108

15615

521 (3.3)

15094

14,599 (96.7)

495 (3.3)

176

15615

15,407 (98.7)

208

39 (18.8)

169 (81.2)

177

15615

0 (0.0)

15615

15,588 (99.8)

27 (0.2)

178

15615

0 (0.0)

15615

13,652 (87.4)

1963 (12.6)

179

15615

0 (0.0)

15615

13,866 (88.8)

1,749 (11.2)

180

15615

47 (0.3)

15568

15,545 (99.85)

23 (0.15)

 


Disclosure:

J. T. Harrington,

Consortium of Rheumatology Researchers of North America CORRONA),

5,

Abbott Laboratories,

5,

Joiner Associates LLC,

4,

Springer Publishers,

7,

Abbott Laboratories,

8,

US Treat to Target Committee,

8,

American Orthopedic Association,

5;

G. Reed,

Corrona,

5,

Corrona,

2;

K. C. Saunders,

Corrona,

3;

L. Lemire,

Corrona,

3;

A. Whitworth,

Corrona,

3;

J. D. Greenberg,

Corrona,Inc.,

1,

Astra Zeneca, Corrona, inc. Novartis, Pfizer,

5;

J. M. Kremer,

Amgen,

2,

Amgen,

5,

Amgen,

8.

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