Summary1 of Performance Measurement Workgroup
Conference Call on
Friday, November 14, 2005 2:00 pm- 3:30 pm EDT
Participants
Kevin Weiss, ACP, chair
Michael Barr, ACR
Sandra Bjork, ACR
John Bott, Employer Health Care Alliance
Cindy Brown, ACS
Edith Budd, AUA
Chuck Cutler, Aetna
Lou Diamond, Medstat
Christopher Donnellan, AAO
Andrea Gelzer, Cigna
Anders Gilberg, AMA
Jay Greissing, ACR
David Hopkins, PBGH
Sheldon Horowitz, ABMS
Elizabeth Hoy, AAO-HNS
Robin Hudson, AUA
Chris Izui, BCBSA
Michelle Johnson, MGMA
Karen Kmetik, AMA
Sandra Lewis, ACOCP
Tammy Lindquist, Health Partners
Carol McCall, Humana
Sharon McGill, AOA
Cherie McNett, AUA
Karen Milgate, MedPAC
Crystal Mottur Pilson, ACP
Michael Mustille, Kaiser Permanente
Ryan Mutter, AHRQ
Frank Opelka, ACOS
Katie Orrico, AAN
Jennifer Padberg, ASTRO
Sandra Peters, AAD
Robert Polvnick, APA
Debbie Robin, AGA
Joachim Roski, NCQA
Richard Scoville, IPP (Foresight Corporation)
David Scrase, PHP
1
Please note that to better organize this summary; some of the comments have been taken out of
chronological order.
Becky Sheirman, AAN
Carol Sieck, AAD
Gale Singer, RPA
Donna Sweet, ACP
Howard Underwood, Aenta
Nancy Wilson, AHRQ
Daniel Wolfson, ABIM
Timothy Zeddies, Independence Blue Cross
Introduction
Kevin Weiss welcomed members of the Workgroup to the call and reviewed the
objectives of the call - to finalize recently revised documents, discuss the recent
efficiency meeting, and review performance measurement development by the American
Medical Association and the American College of Surgeons.
Discussion of Revised “Parameters” Document

The following minor change was approved by the Workgroup: in the sixth bullet, the
phrase “measures of resource consumption” was replaced with “cost of care
measures.”
Discussion of Revised “AQA Principles of ‘Efficiency Measures’” Document
The Principles document was revised at the November 2-3, 2005 Efficiency
Measurement Meeting. The following revisions were accepted or made by the
Workgroup:

In the second introductory paragraph, revised “physician performance” with
“individual physicians, groups and system performance.”

In the definition of efficiency of care, revised to “appropriate level of quality of care.”

In the definition of value of care, revised utility to preference-weighted assessment
for clarity.

Principle #2, revised to include “efficiency and value of care” for consistency within
the document; reference was also added for comparison to appropriate group.

Principle #4, “supplement” was changed to “complement”; and revised to improve
grammar.
Review of “Efficiency” Measurement Meeting
Kevin Weiss provided a general overview of the November 2-3, 2005 efficiency meeting,
the overall objectives of efficiency measurement group, and the creation of the Cost of
Care Measures Exploratory Task Force.

Three major vendors of cost of care measure groupers (Cave Consulting, Medstat,
and Symmetry) presented to the efficiency workgroup on November 2, 2005. The
presentations helped inform the objectives of the group -- to develop standardized
elements that vendors could build into their cost of care tools.

The Cost of Care Measures Exploratory Task Force was formed to develop precise
definitions of the key elements of cost of care measures, including: pre-processing
steps, grouping methodologies, attribution rules, adjustment issues, and costing
methodologies.
Discussion of Development of Sub-specialty and Surgical Measures
Karen Kmetik, AMA, reported on the activities of the AMA Physicians Consortium for
Performance Improvement (PCPI). The PCPI has been contacting various sub-specialties
that do not have existing performance measures and working with them to design
measures. There will be a paper released in early 2006 that will outline their work.
Cynthia Brown reported on the activities of the American College of Surgeons (ACS).
ACS has been working on developing surgical measures that are applicable to all
surgeons. ACS is also looking at NQF-endorsed surgical measures to see if they can be
adapted to the physician level.
Next Steps
Kevin announced a joint AQA/ CMS meeting on December 8, 2005 in Baltimore that
will discuss the uses of medical registries. The Workgroup will also be looking at
patient experience of care measures in the next month.