Jane Anderson

The National Committee for Quality Assurance is finalizing new performance measures that will look at quality of care all the way down to the physician group and even the individual physician level.

The measures, which will form the foundation of a new Health Employer Data and Information Set (HEDIS), could require physicians to begin reporting some quality data to health plans directly—echoing other performance measurement efforts that already are underway nationwide.

The draft ambulatory care quality measures were released for public comment in October. Final measures are expected before the end of the year, according to an NCQA spokesman.

“This is a big change,” said Dr. Bruce Bagley, medical director for quality improvement at the American Academy of Family Physicians (AAFP) and a member of the NCQA committee that approved the draft measures. “Physicians now will begin to report some data from their clinical records, such as 'Why I didn't give an indicated medication.'”

HEDIS, which measures quality of care, is the main tool that health plans use to track and report on their performance to payers.

Until now, HEDIS has used administrative claims data “almost exclusively” to measure quality at the health plan level, said Dr. Bagley. Now, “NCQA has rewritten these specifications so that it's possible to drive the measures down to the physician level. The measures can be used at the plan level or at the physician group level or even at the individual physician level, if there are enough patients.”

The draft measures are designed to allow health plans to report on physician performance for their networks. They include six prevention measures, such as breast cancer screening and influenza vaccination rates, as well as measures that address care for coronary artery disease, depression, and asthma. Measures addressing overuse and misuse of health care services also are part of the proposed HEDIS addition.

The measures include detailed technical specifications and implementation methods, such as appropriate sample sizing, for use by health plans.

The draft measures are not new, Dr. Bagley pointed out. They were included in the National Quality Forum-endorsed National Voluntary Consensus Standards for Physician-Focused Ambulatory Care, and the AQA (formerly the Ambulatory Care Quality Alliance) adopted these measures as part of its Recommended Starter Set of Clinical Performance Measures for Ambulatory Care. Therefore, physician organizations have had an opportunity to see them and comment on them prior to their release as part of HEDIS, Dr. Bagley said.

“We see these [measures] as supplementing a number of national and regional physician-level measurement efforts that are already underway,” said NCQA spokesman Jeff Van Ness. Because NCQA included detailed instructions for implementation, “this lowers the hurdle for plans to begin to move and implement these among physicians,” he said.

Nonetheless, Dr. Bagley said, once these measures are made part of HEDIS, physician groups and individual physicians will need to develop methods to collect the necessary information without resorting to retrospective chart audits.

“We're promoting prospective data collection,” such as checklists that can be filled out at the time of the patient visit, he said.

NCQA released the draft measures for public comment in October. Mr. Van Ness said that most of the comments NCQA has collected have come from large national health plans, although some comments have come from physicians and other stakeholders. He declined to provide information on the content of the comments, citing privacy concerns.

Dr. Lynne Kirk, president of the American College of Physicians, said that her organization's main concern about the new quality measures was any additional paperwork and cost burden they might add to physicians' workloads.

“We aren't saying, 'Don't do it,'” she said. “We're saying, 'Let's do it in a way that actually enhances patient care.' It's going to happen, and in some ways it may improve quality.”

The National Committee for Quality Assurance is finalizing new performance measures that will look at quality of care all the way down to the physician group and even the individual physician level.

The measures, which will form the foundation of a new Health Employer Data and Information Set (HEDIS), could require physicians to begin reporting some quality data to health plans directly—echoing other performance measurement efforts that already are underway nationwide.

The draft ambulatory care quality measures were released for public comment in October. Final measures are expected before the end of the year, according to an NCQA spokesman.

“This is a big change,” said Dr. Bruce Bagley, medical director for quality improvement at the American Academy of Family Physicians (AAFP) and a member of the NCQA committee that approved the draft measures. “Physicians now will begin to report some data from their clinical records, such as 'Why I didn't give an indicated medication.'”

HEDIS, which measures quality of care, is the main tool that health plans use to track and report on their performance to payers.

Until now, HEDIS has used administrative claims data “almost exclusively” to measure quality at the health plan level, said Dr. Bagley. Now, “NCQA has rewritten these specifications so that it's possible to drive the measures down to the physician level. The measures can be used at the plan level or at the physician group level or even at the individual physician level, if there are enough patients.”

The draft measures are designed to allow health plans to report on physician performance for their networks. They include six prevention measures, such as breast cancer screening and influenza vaccination rates, as well as measures that address care for coronary artery disease, depression, and asthma. Measures addressing overuse and misuse of health care services also are part of the proposed HEDIS addition.

The measures include detailed technical specifications and implementation methods, such as appropriate sample sizing, for use by health plans.

The draft measures are not new, Dr. Bagley pointed out. They were included in the National Quality Forum-endorsed National Voluntary Consensus Standards for Physician-Focused Ambulatory Care, and the AQA (formerly the Ambulatory Care Quality Alliance) adopted these measures as part of its Recommended Starter Set of Clinical Performance Measures for Ambulatory Care. Therefore, physician organizations have had an opportunity to see them and comment on them prior to their release as part of HEDIS, Dr. Bagley said.

“We see these [measures] as supplementing a number of national and regional physician-level measurement efforts that are already underway,” said NCQA spokesman Jeff Van Ness. Because NCQA included detailed instructions for implementation, “this lowers the hurdle for plans to begin to move and implement these among physicians,” he said.

Nonetheless, Dr. Bagley said, once these measures are made part of HEDIS, physician groups and individual physicians will need to develop methods to collect the necessary information without resorting to retrospective chart audits.

“We're promoting prospective data collection,” such as checklists that can be filled out at the time of the patient visit, he said.

NCQA released the draft measures for public comment in October. Mr. Van Ness said that most of the comments NCQA has collected have come from large national health plans, although some comments have come from physicians and other stakeholders. He declined to provide information on the content of the comments, citing privacy concerns.

Dr. Lynne Kirk, president of the American College of Physicians, said that her organization's main concern about the new quality measures was any additional paperwork and cost burden they might add to physicians' workloads.

“We aren't saying, 'Don't do it,'” she said. “We're saying, 'Let's do it in a way that actually enhances patient care.' It's going to happen, and in some ways it may improve quality.”

The National Committee for Quality Assurance is finalizing new performance measures that will look at quality of care all the way down to the physician group and even the individual physician level.

The measures, which will form the foundation of a new Health Employer Data and Information Set (HEDIS), could require physicians to begin reporting some quality data to health plans directly—echoing other performance measurement efforts that already are underway nationwide.

The draft ambulatory care quality measures were released for public comment in October. Final measures are expected before the end of the year, according to an NCQA spokesman.

“This is a big change,” said Dr. Bruce Bagley, medical director for quality improvement at the American Academy of Family Physicians (AAFP) and a member of the NCQA committee that approved the draft measures. “Physicians now will begin to report some data from their clinical records, such as 'Why I didn't give an indicated medication.'”

HEDIS, which measures quality of care, is the main tool that health plans use to track and report on their performance to payers.

Until now, HEDIS has used administrative claims data “almost exclusively” to measure quality at the health plan level, said Dr. Bagley. Now, “NCQA has rewritten these specifications so that it's possible to drive the measures down to the physician level. The measures can be used at the plan level or at the physician group level or even at the individual physician level, if there are enough patients.”

The draft measures are designed to allow health plans to report on physician performance for their networks. They include six prevention measures, such as breast cancer screening and influenza vaccination rates, as well as measures that address care for coronary artery disease, depression, and asthma. Measures addressing overuse and misuse of health care services also are part of the proposed HEDIS addition.

The measures include detailed technical specifications and implementation methods, such as appropriate sample sizing, for use by health plans.

The draft measures are not new, Dr. Bagley pointed out. They were included in the National Quality Forum-endorsed National Voluntary Consensus Standards for Physician-Focused Ambulatory Care, and the AQA (formerly the Ambulatory Care Quality Alliance) adopted these measures as part of its Recommended Starter Set of Clinical Performance Measures for Ambulatory Care. Therefore, physician organizations have had an opportunity to see them and comment on them prior to their release as part of HEDIS, Dr. Bagley said.

“We see these [measures] as supplementing a number of national and regional physician-level measurement efforts that are already underway,” said NCQA spokesman Jeff Van Ness. Because NCQA included detailed instructions for implementation, “this lowers the hurdle for plans to begin to move and implement these among physicians,” he said.

Nonetheless, Dr. Bagley said, once these measures are made part of HEDIS, physician groups and individual physicians will need to develop methods to collect the necessary information without resorting to retrospective chart audits.

“We're promoting prospective data collection,” such as checklists that can be filled out at the time of the patient visit, he said.

NCQA released the draft measures for public comment in October. Mr. Van Ness said that most of the comments NCQA has collected have come from large national health plans, although some comments have come from physicians and other stakeholders. He declined to provide information on the content of the comments, citing privacy concerns.

Dr. Lynne Kirk, president of the American College of Physicians, said that her organization's main concern about the new quality measures was any additional paperwork and cost burden they might add to physicians' workloads.

“We aren't saying, 'Don't do it,'” she said. “We're saying, 'Let's do it in a way that actually enhances patient care.' It's going to happen, and in some ways it may improve quality.”

The National Committee for Quality Assurance is finalizing new performance measures that will look at quality of care all the way down to the physician group and even the individual physician level.

The measures, which will form the foundation of a new Health Employer Data and Information Set (HEDIS), could require physicians to begin reporting some quality data to health plans directly—echoing other performance measurement efforts already underway nationwide.

The draft ambulatory care quality measures were released for public comment in October. Final measures are expected before the end of the year, according to an NCQA spokesman.

"This is a big change," said Dr. Bruce Bagley, medical director for quality improvement at the American Academy of Family Physicians (AAFP) and a member of the NCQA committee that approved the draft measures. "Physicians now will begin to report some data from their clinical records, such as 'Why I didn't give an indicated medication.'"

HEDIS, which measures quality of care, is the main tool that health plans use to track and report on their performance to payers. Until now, HEDIS has used administrative claims data "almost exclusively" to measure quality at the health plan level, said Dr. Bagley. Now, "NCQA has rewritten these specifications so that it's possible to drive the measures down to the physician level. The measures can be used at the plan level or at the physician group level or even at the individual physician level, if there are enough patients."

The draft measures are designed to allow health plans to report on physician performance for their networks. They include six prevention measures, such as breast cancer screening and influenza vaccination rates, as well as measures that address care for coronary artery disease, depression, and asthma. Measures addressing overuse and misuse of health care services also are part of the proposed HEDIS addition.

The measures include detailed technical specifications and implementation methods, such as appropriate sample sizing, for use by health plans. The draft measures are not new, Dr. Bagley pointed out. They were included in the National Quality Forum-endorsed National Voluntary Consensus Standards for Physician-Focused Ambulatory Care, and the AQA (formerly the Ambulatory Care Quality Alliance) adopted these measures as part of its Recommended Starter Set of Clinical Performance Measures for Ambulatory Care. Therefore, physician organizations have had an opportunity to see them and comment on them prior to their release as part of HEDIS, Dr. Bagley said.

"We see these [measures] as supplementing a number of national and regional physician-level measurement efforts that are already underway," said NCQA spokesman Jeff Van Ness. Because NCQA included detailed instructions for implementation, "this lowers the hurdle for plans to begin to move and implement these among physicians," he said.

Nonetheless, Dr. Bagley said, once these measures are made part of HEDIS, physician groups and individual physicians will need to develop methods to collect the necessary information without resorting to retrospective chart audits. "We're promoting prospective data collection," such as checklists that can be filled out at the time of the patient visit, he said.

NCQA released the draft measures for public comment in October. Mr. Van Ness said that most of the comments NCQA has collected have come from large national health plans, although some comments have come from physicians and other stakeholders. He declined to provide information on the content of the comments, citing privacy concerns.

Dr. Lynne Kirk, president of the American College of Physicians, said that her organization's main concern about the new quality measures was any additional paperwork and cost burden they might add to physicians' workloads.

The National Committee for Quality Assurance is finalizing new performance measures that will look at quality of care all the way down to the physician group and even the individual physician level.

The measures, which will form the foundation of a new Health Employer Data and Information Set (HEDIS), could require physicians to begin reporting some quality data to health plans directly—echoing other performance measurement efforts already underway nationwide.

The draft ambulatory care quality measures were released for public comment in October. Final measures are expected before the end of the year, according to an NCQA spokesman.

"This is a big change," said Dr. Bruce Bagley, medical director for quality improvement at the American Academy of Family Physicians (AAFP) and a member of the NCQA committee that approved the draft measures. "Physicians now will begin to report some data from their clinical records, such as 'Why I didn't give an indicated medication.'"

HEDIS, which measures quality of care, is the main tool that health plans use to track and report on their performance to payers. Until now, HEDIS has used administrative claims data "almost exclusively" to measure quality at the health plan level, said Dr. Bagley. Now, "NCQA has rewritten these specifications so that it's possible to drive the measures down to the physician level. The measures can be used at the plan level or at the physician group level or even at the individual physician level, if there are enough patients."

The draft measures are designed to allow health plans to report on physician performance for their networks. They include six prevention measures, such as breast cancer screening and influenza vaccination rates, as well as measures that address care for coronary artery disease, depression, and asthma. Measures addressing overuse and misuse of health care services also are part of the proposed HEDIS addition.

The measures include detailed technical specifications and implementation methods, such as appropriate sample sizing, for use by health plans. The draft measures are not new, Dr. Bagley pointed out. They were included in the National Quality Forum-endorsed National Voluntary Consensus Standards for Physician-Focused Ambulatory Care, and the AQA (formerly the Ambulatory Care Quality Alliance) adopted these measures as part of its Recommended Starter Set of Clinical Performance Measures for Ambulatory Care. Therefore, physician organizations have had an opportunity to see them and comment on them prior to their release as part of HEDIS, Dr. Bagley said.

"We see these [measures] as supplementing a number of national and regional physician-level measurement efforts that are already underway," said NCQA spokesman Jeff Van Ness. Because NCQA included detailed instructions for implementation, "this lowers the hurdle for plans to begin to move and implement these among physicians," he said.

Nonetheless, Dr. Bagley said, once these measures are made part of HEDIS, physician groups and individual physicians will need to develop methods to collect the necessary information without resorting to retrospective chart audits. "We're promoting prospective data collection," such as checklists that can be filled out at the time of the patient visit, he said.

NCQA released the draft measures for public comment in October. Mr. Van Ness said that most of the comments NCQA has collected have come from large national health plans, although some comments have come from physicians and other stakeholders. He declined to provide information on the content of the comments, citing privacy concerns.

Dr. Lynne Kirk, president of the American College of Physicians, said that her organization's main concern about the new quality measures was any additional paperwork and cost burden they might add to physicians' workloads.

The National Committee for Quality Assurance is finalizing new performance measures that will look at quality of care all the way down to the physician group and even the individual physician level.

The measures, which will form the foundation of a new Health Employer Data and Information Set (HEDIS), could require physicians to begin reporting some quality data to health plans directly—echoing other performance measurement efforts already underway nationwide.

The draft ambulatory care quality measures were released for public comment in October. Final measures are expected before the end of the year, according to an NCQA spokesman.

"This is a big change," said Dr. Bruce Bagley, medical director for quality improvement at the American Academy of Family Physicians (AAFP) and a member of the NCQA committee that approved the draft measures. "Physicians now will begin to report some data from their clinical records, such as 'Why I didn't give an indicated medication.'"

HEDIS, which measures quality of care, is the main tool that health plans use to track and report on their performance to payers. Until now, HEDIS has used administrative claims data "almost exclusively" to measure quality at the health plan level, said Dr. Bagley. Now, "NCQA has rewritten these specifications so that it's possible to drive the measures down to the physician level. The measures can be used at the plan level or at the physician group level or even at the individual physician level, if there are enough patients."

The draft measures are designed to allow health plans to report on physician performance for their networks. They include six prevention measures, such as breast cancer screening and influenza vaccination rates, as well as measures that address care for coronary artery disease, depression, and asthma. Measures addressing overuse and misuse of health care services also are part of the proposed HEDIS addition.

The measures include detailed technical specifications and implementation methods, such as appropriate sample sizing, for use by health plans. The draft measures are not new, Dr. Bagley pointed out. They were included in the National Quality Forum-endorsed National Voluntary Consensus Standards for Physician-Focused Ambulatory Care, and the AQA (formerly the Ambulatory Care Quality Alliance) adopted these measures as part of its Recommended Starter Set of Clinical Performance Measures for Ambulatory Care. Therefore, physician organizations have had an opportunity to see them and comment on them prior to their release as part of HEDIS, Dr. Bagley said.

"We see these [measures] as supplementing a number of national and regional physician-level measurement efforts that are already underway," said NCQA spokesman Jeff Van Ness. Because NCQA included detailed instructions for implementation, "this lowers the hurdle for plans to begin to move and implement these among physicians," he said.

Nonetheless, Dr. Bagley said, once these measures are made part of HEDIS, physician groups and individual physicians will need to develop methods to collect the necessary information without resorting to retrospective chart audits. "We're promoting prospective data collection," such as checklists that can be filled out at the time of the patient visit, he said.

NCQA released the draft measures for public comment in October. Mr. Van Ness said that most of the comments NCQA has collected have come from large national health plans, although some comments have come from physicians and other stakeholders. He declined to provide information on the content of the comments, citing privacy concerns.

Dr. Lynne Kirk, president of the American College of Physicians, said that her organization's main concern about the new quality measures was any additional paperwork and cost burden they might add to physicians' workloads.

The National Committee for Quality Assurance is finalizing new performance measures that will look at quality of care all the way down to the physician group and even the individual physician level.

The measures, which will form the foundation of a new Health Employer Data and Information Set (HEDIS), could require physicians to begin reporting some quality data to health plans directly—echoing other performance measurement efforts that already are underway nationwide.

The draft ambulatory care quality measures were released for public comment in October. Final measures are expected before the end of the year, said an NCQA spokesman.

“This is a big change,” said Dr. Bruce Bagley, medical director for quality improvement at the American Academy of Family Physicians (AAFP) and a member of the NCQA committee that approved the draft measures.

“Physicians now will begin to report some data from their clinical records, such as 'Why I didn't give an indicated medication.'”

HEDIS, which measures quality of care, is the main tool that health plans use to track and report on their performance to payers.

Until now, HEDIS has used administrative claims data “almost exclusively” to measure quality at the health plan level, said Dr. Bagley.

Now, “NCQA has rewritten these specifications so that it's possible to drive the measures down to the physician level. The measures can be used at the plan level or at the physician group level or even at the individual physician level, if there are enough patients.”

The draft measures are designed to allow health plans to report on physician performance for their networks.

They include six prevention measures, such as breast cancer screening and influenza vaccination rates, as well as measures that address care for those with coronary artery disease, depression, and asthma. Measures that address the overuse and misuse of health care services also are part of the proposed HEDIS addition.

The measures include detailed technical specifications and implementation methods, such as appropriate sample sizing, for use by health plans.

The draft measures are not new, Dr. Bagley pointed out. They were included in the National Quality Forum-endorsed National Voluntary Consensus Standards for Physician-Focused Ambulatory Care, and the AQA (which was formerly known as the the Ambulatory Care Quality Alliance) adopted these measures as part of its Recommended Starter Set of Clinical Performance Measures for Ambulatory Care.

Therefore, physician organizations have had an opportunity to see them and to comment on them prior to their release as part of HEDIS, Dr. Bagley said.

“We see these [measures] as supplementing a number of national and regional physician-level measurement efforts that are already underway,” said NCQA spokesman Jeff Van Ness.

Because NCQA included detailed instructions for implementation, “this lowers the hurdle for plans to begin to move and implement these among physicians,” he said.

Nonetheless, Dr. Bagley said, once these measures are made part of HEDIS, physician groups and individual physicians will need to develop methods to collect the necessary information without resorting to retrospective chart audits.

“We're promoting prospective data collection,” such as checklists that can be filled out at the time of the patient visit, Dr. Bagley said.

NCQA released the draft measures for public comment in October. Mr. Van Ness said that most of the comments NCQA has collected have come from large national health plans, although some comments have come from physicians and from other stakeholders.

He declined to provide information on the content of the comments, citing privacy concerns.

Dr. Lynne Kirk, who is the president of the American College of Physicians, said that her organization's main concern about the new quality measures was that any additional paperwork and extra costs related to the measures would become a burden to physicians.

“We aren't saying, 'Don't do it,'” she said. “We're saying, 'Let's do it in a way that actually enhances patient care.' It's going to happen, and in some ways it may improve quality.”

The National Committee for Quality Assurance is finalizing new performance measures that will look at quality of care all the way down to the physician group and even the individual physician level.

The measures, which will form the foundation of a new Health Employer Data and Information Set (HEDIS), could require physicians to begin reporting some quality data to health plans directly—echoing other performance measurement efforts that already are underway nationwide.

The draft ambulatory care quality measures were released for public comment in October. Final measures are expected before the end of the year, said an NCQA spokesman.

“This is a big change,” said Dr. Bruce Bagley, medical director for quality improvement at the American Academy of Family Physicians (AAFP) and a member of the NCQA committee that approved the draft measures.

“Physicians now will begin to report some data from their clinical records, such as 'Why I didn't give an indicated medication.'”

HEDIS, which measures quality of care, is the main tool that health plans use to track and report on their performance to payers.

Until now, HEDIS has used administrative claims data “almost exclusively” to measure quality at the health plan level, said Dr. Bagley.

Now, “NCQA has rewritten these specifications so that it's possible to drive the measures down to the physician level. The measures can be used at the plan level or at the physician group level or even at the individual physician level, if there are enough patients.”

The draft measures are designed to allow health plans to report on physician performance for their networks.

They include six prevention measures, such as breast cancer screening and influenza vaccination rates, as well as measures that address care for those with coronary artery disease, depression, and asthma. Measures that address the overuse and misuse of health care services also are part of the proposed HEDIS addition.

The measures include detailed technical specifications and implementation methods, such as appropriate sample sizing, for use by health plans.

The draft measures are not new, Dr. Bagley pointed out. They were included in the National Quality Forum-endorsed National Voluntary Consensus Standards for Physician-Focused Ambulatory Care, and the AQA (which was formerly known as the the Ambulatory Care Quality Alliance) adopted these measures as part of its Recommended Starter Set of Clinical Performance Measures for Ambulatory Care.

Therefore, physician organizations have had an opportunity to see them and to comment on them prior to their release as part of HEDIS, Dr. Bagley said.

“We see these [measures] as supplementing a number of national and regional physician-level measurement efforts that are already underway,” said NCQA spokesman Jeff Van Ness.

Because NCQA included detailed instructions for implementation, “this lowers the hurdle for plans to begin to move and implement these among physicians,” he said.

Nonetheless, Dr. Bagley said, once these measures are made part of HEDIS, physician groups and individual physicians will need to develop methods to collect the necessary information without resorting to retrospective chart audits.

“We're promoting prospective data collection,” such as checklists that can be filled out at the time of the patient visit, Dr. Bagley said.

NCQA released the draft measures for public comment in October. Mr. Van Ness said that most of the comments NCQA has collected have come from large national health plans, although some comments have come from physicians and from other stakeholders.

He declined to provide information on the content of the comments, citing privacy concerns.

Dr. Lynne Kirk, who is the president of the American College of Physicians, said that her organization's main concern about the new quality measures was that any additional paperwork and extra costs related to the measures would become a burden to physicians.

“We aren't saying, 'Don't do it,'” she said. “We're saying, 'Let's do it in a way that actually enhances patient care.' It's going to happen, and in some ways it may improve quality.”

The National Committee for Quality Assurance is finalizing new performance measures that will look at quality of care all the way down to the physician group and even the individual physician level.

The measures, which will form the foundation of a new Health Employer Data and Information Set (HEDIS), could require physicians to begin reporting some quality data to health plans directly—echoing other performance measurement efforts that already are underway nationwide.

The draft ambulatory care quality measures were released for public comment in October. Final measures are expected before the end of the year, said an NCQA spokesman.

“This is a big change,” said Dr. Bruce Bagley, medical director for quality improvement at the American Academy of Family Physicians (AAFP) and a member of the NCQA committee that approved the draft measures.

“Physicians now will begin to report some data from their clinical records, such as 'Why I didn't give an indicated medication.'”

HEDIS, which measures quality of care, is the main tool that health plans use to track and report on their performance to payers.

Until now, HEDIS has used administrative claims data “almost exclusively” to measure quality at the health plan level, said Dr. Bagley.

Now, “NCQA has rewritten these specifications so that it's possible to drive the measures down to the physician level. The measures can be used at the plan level or at the physician group level or even at the individual physician level, if there are enough patients.”

The draft measures are designed to allow health plans to report on physician performance for their networks.

They include six prevention measures, such as breast cancer screening and influenza vaccination rates, as well as measures that address care for those with coronary artery disease, depression, and asthma. Measures that address the overuse and misuse of health care services also are part of the proposed HEDIS addition.

The measures include detailed technical specifications and implementation methods, such as appropriate sample sizing, for use by health plans.

The draft measures are not new, Dr. Bagley pointed out. They were included in the National Quality Forum-endorsed National Voluntary Consensus Standards for Physician-Focused Ambulatory Care, and the AQA (which was formerly known as the the Ambulatory Care Quality Alliance) adopted these measures as part of its Recommended Starter Set of Clinical Performance Measures for Ambulatory Care.

Therefore, physician organizations have had an opportunity to see them and to comment on them prior to their release as part of HEDIS, Dr. Bagley said.

“We see these [measures] as supplementing a number of national and regional physician-level measurement efforts that are already underway,” said NCQA spokesman Jeff Van Ness.

Because NCQA included detailed instructions for implementation, “this lowers the hurdle for plans to begin to move and implement these among physicians,” he said.

Nonetheless, Dr. Bagley said, once these measures are made part of HEDIS, physician groups and individual physicians will need to develop methods to collect the necessary information without resorting to retrospective chart audits.

“We're promoting prospective data collection,” such as checklists that can be filled out at the time of the patient visit, Dr. Bagley said.

NCQA released the draft measures for public comment in October. Mr. Van Ness said that most of the comments NCQA has collected have come from large national health plans, although some comments have come from physicians and from other stakeholders.

He declined to provide information on the content of the comments, citing privacy concerns.

Dr. Lynne Kirk, who is the president of the American College of Physicians, said that her organization's main concern about the new quality measures was that any additional paperwork and extra costs related to the measures would become a burden to physicians.

“We aren't saying, 'Don't do it,'” she said. “We're saying, 'Let's do it in a way that actually enhances patient care.' It's going to happen, and in some ways it may improve quality.”

Overall mortality for Medicare patients at U.S. hospitals has declined by nearly 8% since 2003, but a typical patient has, on average, a 69% lower chance of dying at a five-star rated hospital than at a one-star rated institution, according to an analysis by HealthGrades, an independent health care ratings organization.

This “quality chasm” has grown by nearly 5% since last year's study, said Dr. Samantha Collier, vice president of medical affairs at HealthGrades and author of the report, “The Ninth Annual HealthGrades Hospital Quality in America Study.”

According to the study, more than 300,000 lives of Medicare patients could have been saved during the 3 years studied if all hospitals performed at the level of hospitals rated with five stars.

The data showed that half of these potentially preventable deaths were associated with just four diagnoses: heart failure (33,543 potentially preventable deaths), sepsis (38,560), community-acquired pneumonia (37,593), and respiratory failure (40,093).

The study examined mortality rates for 18 diagnoses and procedures. For example, typical patients having coronary artery bypass surgery (CABG) have a 73% lower risk of death, on average, at a five-star rated hospital than a one-star rated hospital.

If all Medicare CABG patients from 2003 to 2005 went to five-star hospitals, 5,308 lives could have been saved, the report said.

For stroke patients, mortality is 51% lower if they are admitted to a five-star rated hospital than to a one-star hospital, and 27,458 lives could have been saved if all stroke patients went to five-star hospitals.

Dr. Collier urged physicians to read the report in order to find out where their hospitals stand in the ratings, and to work toward quality improvement in all areas of hospital care, not just in the care they provide.

“Physicians are important stakeholders, but they're not the only ones,” said Dr. Collier, who noted that patients can have a greater risk of death at lower-rated hospitals, even if their physician is top-rated.

“Physicians can collaborate with hospitals to understand some of the ways they can improve care,” she said. “There are physicians who are interested in quality improvement, and hospitals are waking up and starting to pay for that work.”

The HealthGrades study analyzed 40.6 million Medicare hospitalization records, from the years 2003 through 2005, to rate the quality of care at each of the nation's more than 5,000 nonfederal hospitals.

This year's report says that mortality rates among Medicare patients continue to decline, but that the gap between the top-rated and bottom-rated hospitals continues to grow.

“The good news is, things seem to be improving,” Dr. Collier said. “The best are getting better, and the others are too, but at slower rate.”

Compared with last year's study, the disparity in mortality between the lowest- and highest-rated hospitals has increased by 5%.That same typical patient would have, on average, an approximately 49% lower chance of dying in a five-star rated hospital than in an average U.S. hospital; that represents an increase of about 7% in the disparity, compared with last year's study.

HealthGrades, based in Golden, Colo., posts the ratings free of charge at its consumer Web site, www.healthgrades.com

Dr. Collier suggested that physicians at the very least know how their hospitals rate in the rankings: “If you don't know how your hospital performed in some of these key areas, you need to know that.”

Increasingly, patients want to know how their providers rank—and it's critical for physicians to understand statistics such as the HealthGrades report and to be able to discuss them with their patients.

“Patients are getting savvy,” she said. “A lot of physicians know there's a lot of variation, but they think it's not in their hospital and not in their practice. If the doctor dismisses it, especially in a patronizing way, the patient will find another doctor.”

Overall mortality for Medicare patients at U.S. hospitals has declined by nearly 8% since 2003, but a typical patient has, on average, a 69% lower chance of dying at a five-star rated hospital than at a one-star rated institution, according to an analysis by HealthGrades, an independent health care ratings organization.

This “quality chasm” has grown by nearly 5% since last year's study, said Dr. Samantha Collier, vice president of medical affairs at HealthGrades and author of the report, “The Ninth Annual HealthGrades Hospital Quality in America Study.”

According to the study, more than 300,000 lives of Medicare patients could have been saved during the 3 years studied if all hospitals performed at the level of hospitals rated with five stars.

The data showed that half of these potentially preventable deaths were associated with just four diagnoses: heart failure (33,543 potentially preventable deaths), sepsis (38,560), community-acquired pneumonia (37,593), and respiratory failure (40,093).

The study examined mortality rates for 18 diagnoses and procedures. For example, typical patients having coronary artery bypass surgery (CABG) have a 73% lower risk of death, on average, at a five-star rated hospital than a one-star rated hospital.

If all Medicare CABG patients from 2003 to 2005 went to five-star hospitals, 5,308 lives could have been saved, the report said.

For stroke patients, mortality is 51% lower if they are admitted to a five-star rated hospital than to a one-star hospital, and 27,458 lives could have been saved if all stroke patients went to five-star hospitals.

Dr. Collier urged physicians to read the report in order to find out where their hospitals stand in the ratings, and to work toward quality improvement in all areas of hospital care, not just in the care they provide.

“Physicians are important stakeholders, but they're not the only ones,” said Dr. Collier, who noted that patients can have a greater risk of death at lower-rated hospitals, even if their physician is top-rated.

“Physicians can collaborate with hospitals to understand some of the ways they can improve care,” she said. “There are physicians who are interested in quality improvement, and hospitals are waking up and starting to pay for that work.”

The HealthGrades study analyzed 40.6 million Medicare hospitalization records, from the years 2003 through 2005, to rate the quality of care at each of the nation's more than 5,000 nonfederal hospitals.

This year's report says that mortality rates among Medicare patients continue to decline, but that the gap between the top-rated and bottom-rated hospitals continues to grow.

“The good news is, things seem to be improving,” Dr. Collier said. “The best are getting better, and the others are too, but at slower rate.”

Compared with last year's study, the disparity in mortality between the lowest- and highest-rated hospitals has increased by 5%.That same typical patient would have, on average, an approximately 49% lower chance of dying in a five-star rated hospital than in an average U.S. hospital; that represents an increase of about 7% in the disparity, compared with last year's study.

HealthGrades, based in Golden, Colo., posts the ratings free of charge at its consumer Web site, www.healthgrades.com

Dr. Collier suggested that physicians at the very least know how their hospitals rate in the rankings: “If you don't know how your hospital performed in some of these key areas, you need to know that.”

Increasingly, patients want to know how their providers rank—and it's critical for physicians to understand statistics such as the HealthGrades report and to be able to discuss them with their patients.

“Patients are getting savvy,” she said. “A lot of physicians know there's a lot of variation, but they think it's not in their hospital and not in their practice. If the doctor dismisses it, especially in a patronizing way, the patient will find another doctor.”

Overall mortality for Medicare patients at U.S. hospitals has declined by nearly 8% since 2003, but a typical patient has, on average, a 69% lower chance of dying at a five-star rated hospital than at a one-star rated institution, according to an analysis by HealthGrades, an independent health care ratings organization.

This “quality chasm” has grown by nearly 5% since last year's study, said Dr. Samantha Collier, vice president of medical affairs at HealthGrades and author of the report, “The Ninth Annual HealthGrades Hospital Quality in America Study.”

According to the study, more than 300,000 lives of Medicare patients could have been saved during the 3 years studied if all hospitals performed at the level of hospitals rated with five stars.

The data showed that half of these potentially preventable deaths were associated with just four diagnoses: heart failure (33,543 potentially preventable deaths), sepsis (38,560), community-acquired pneumonia (37,593), and respiratory failure (40,093).

The study examined mortality rates for 18 diagnoses and procedures. For example, typical patients having coronary artery bypass surgery (CABG) have a 73% lower risk of death, on average, at a five-star rated hospital than a one-star rated hospital.

If all Medicare CABG patients from 2003 to 2005 went to five-star hospitals, 5,308 lives could have been saved, the report said.

For stroke patients, mortality is 51% lower if they are admitted to a five-star rated hospital than to a one-star hospital, and 27,458 lives could have been saved if all stroke patients went to five-star hospitals.

Dr. Collier urged physicians to read the report in order to find out where their hospitals stand in the ratings, and to work toward quality improvement in all areas of hospital care, not just in the care they provide.

“Physicians are important stakeholders, but they're not the only ones,” said Dr. Collier, who noted that patients can have a greater risk of death at lower-rated hospitals, even if their physician is top-rated.

“Physicians can collaborate with hospitals to understand some of the ways they can improve care,” she said. “There are physicians who are interested in quality improvement, and hospitals are waking up and starting to pay for that work.”

The HealthGrades study analyzed 40.6 million Medicare hospitalization records, from the years 2003 through 2005, to rate the quality of care at each of the nation's more than 5,000 nonfederal hospitals.

This year's report says that mortality rates among Medicare patients continue to decline, but that the gap between the top-rated and bottom-rated hospitals continues to grow.

“The good news is, things seem to be improving,” Dr. Collier said. “The best are getting better, and the others are too, but at slower rate.”

Compared with last year's study, the disparity in mortality between the lowest- and highest-rated hospitals has increased by 5%.That same typical patient would have, on average, an approximately 49% lower chance of dying in a five-star rated hospital than in an average U.S. hospital; that represents an increase of about 7% in the disparity, compared with last year's study.

HealthGrades, based in Golden, Colo., posts the ratings free of charge at its consumer Web site, www.healthgrades.com

Dr. Collier suggested that physicians at the very least know how their hospitals rate in the rankings: “If you don't know how your hospital performed in some of these key areas, you need to know that.”

Increasingly, patients want to know how their providers rank—and it's critical for physicians to understand statistics such as the HealthGrades report and to be able to discuss them with their patients.

“Patients are getting savvy,” she said. “A lot of physicians know there's a lot of variation, but they think it's not in their hospital and not in their practice. If the doctor dismisses it, especially in a patronizing way, the patient will find another doctor.”

The U.S. Department of Health and Human Services should gradually replace Medicare's current payment system with a pay-for-performance system that would reward physicians and other providers for efficiency along with patient-centered, quality care, according to a report from the Institute of Medicine.

Pay-for-performance plans do not yet have an established track record of improving care, so IOM's report, “Rewarding Provider Performance: Aligning Incentives in Medicare,” urges a phased-in program that will evaluate pay-for-performance initiatives as they are implemented.

Pay for performance will help transform the Medicare payment system into one that rewards both higher value and better outcomes, Robert Reischauer, Ph.D., president of the Washington-based Urban Institute, said at a press briefing sponsored by IOM. Dr. Reischauer served on the committee that wrote the report.

“The committee does not feel that pay for performance is the magic bullet,” he said. “Pay for performance should be considered one of several key elements needed to restructure the current payment system.”

Any changes in Medicare's payment system would need to be approved by Congress.

The panel's report urged lawmakers to adopt an initial system that would reduce base Medicare payments across the board and use the money to fund rewards for strong performance. At the same time, Medicare officials would evaluate the program to make certain it is having the desired effects.

The proportion of Medicare payment withheld would be small at first, and providers would be compensated both for excellent work and for improving their performance in areas that encompass care quality, efficiency, and “patient centeredness.”

“We are recommending a performance-based system in which both excellence is rewarded and significant improvement is rewarded,” Dr. Reischauer said. “Everyone can play and everyone can get back the money that was withheld initially from them.”

Many large health care providers and organizations already have the capacity to begin participating in a Medicare pay-for-performance system and should be required to do so as soon as it is launched, the IOM report said. However, participation by small physician practices should be voluntary for the first 3 years.

Gail Wilensky, Ph.D., a senior fellow at Project HOPE and a member of the IOM panel, said she would expect most physicians to welcome a new, pay-for-performance-based system.

“Many physicians have complained that, when participating in Medicare, they are penalized if they provide care that's more prevention-oriented,” said Dr. Wilensky, who noted that a pay-for-performance-based system would reward those physicians. “This is in many ways a response to some of that criticism by physicians.”

Panel member Dr. Robert Galvin, director of global health care for General Electric Co., agreed.

“There is a substantial percentage of physicians who like these programs [and] who like the idea of working in teams and having their performance rewarded,” Dr. Galvin said. “There is already a culture shift going on.”

The full report is available at www.iom.edu

The U.S. Department of Health and Human Services should gradually replace Medicare's current payment system with a pay-for-performance system that would reward physicians and other providers for efficiency along with patient-centered, quality care, according to a report from the Institute of Medicine.

Pay-for-performance plans do not yet have an established track record of improving care, so IOM's report, “Rewarding Provider Performance: Aligning Incentives in Medicare,” urges a phased-in program that will evaluate pay-for-performance initiatives as they are implemented.

Pay for performance will help transform the Medicare payment system into one that rewards both higher value and better outcomes, Robert Reischauer, Ph.D., president of the Washington-based Urban Institute, said at a press briefing sponsored by IOM. Dr. Reischauer served on the committee that wrote the report.

“The committee does not feel that pay for performance is the magic bullet,” he said. “Pay for performance should be considered one of several key elements needed to restructure the current payment system.”

Any changes in Medicare's payment system would need to be approved by Congress.

The panel's report urged lawmakers to adopt an initial system that would reduce base Medicare payments across the board and use the money to fund rewards for strong performance. At the same time, Medicare officials would evaluate the program to make certain it is having the desired effects.

The proportion of Medicare payment withheld would be small at first, and providers would be compensated both for excellent work and for improving their performance in areas that encompass care quality, efficiency, and “patient centeredness.”

“We are recommending a performance-based system in which both excellence is rewarded and significant improvement is rewarded,” Dr. Reischauer said. “Everyone can play and everyone can get back the money that was withheld initially from them.”

Many large health care providers and organizations already have the capacity to begin participating in a Medicare pay-for-performance system and should be required to do so as soon as it is launched, the IOM report said. However, participation by small physician practices should be voluntary for the first 3 years.

Gail Wilensky, Ph.D., a senior fellow at Project HOPE and a member of the IOM panel, said she would expect most physicians to welcome a new, pay-for-performance-based system.

“Many physicians have complained that, when participating in Medicare, they are penalized if they provide care that's more prevention-oriented,” said Dr. Wilensky, who noted that a pay-for-performance-based system would reward those physicians. “This is in many ways a response to some of that criticism by physicians.”

Panel member Dr. Robert Galvin, director of global health care for General Electric Co., agreed.

“There is a substantial percentage of physicians who like these programs [and] who like the idea of working in teams and having their performance rewarded,” Dr. Galvin said. “There is already a culture shift going on.”

The full report is available at www.iom.edu

The U.S. Department of Health and Human Services should gradually replace Medicare's current payment system with a pay-for-performance system that would reward physicians and other providers for efficiency along with patient-centered, quality care, according to a report from the Institute of Medicine.

Pay-for-performance plans do not yet have an established track record of improving care, so IOM's report, “Rewarding Provider Performance: Aligning Incentives in Medicare,” urges a phased-in program that will evaluate pay-for-performance initiatives as they are implemented.

Pay for performance will help transform the Medicare payment system into one that rewards both higher value and better outcomes, Robert Reischauer, Ph.D., president of the Washington-based Urban Institute, said at a press briefing sponsored by IOM. Dr. Reischauer served on the committee that wrote the report.

“The committee does not feel that pay for performance is the magic bullet,” he said. “Pay for performance should be considered one of several key elements needed to restructure the current payment system.”

Any changes in Medicare's payment system would need to be approved by Congress.

The panel's report urged lawmakers to adopt an initial system that would reduce base Medicare payments across the board and use the money to fund rewards for strong performance. At the same time, Medicare officials would evaluate the program to make certain it is having the desired effects.

The proportion of Medicare payment withheld would be small at first, and providers would be compensated both for excellent work and for improving their performance in areas that encompass care quality, efficiency, and “patient centeredness.”

“We are recommending a performance-based system in which both excellence is rewarded and significant improvement is rewarded,” Dr. Reischauer said. “Everyone can play and everyone can get back the money that was withheld initially from them.”

Many large health care providers and organizations already have the capacity to begin participating in a Medicare pay-for-performance system and should be required to do so as soon as it is launched, the IOM report said. However, participation by small physician practices should be voluntary for the first 3 years.

Gail Wilensky, Ph.D., a senior fellow at Project HOPE and a member of the IOM panel, said she would expect most physicians to welcome a new, pay-for-performance-based system.

“Many physicians have complained that, when participating in Medicare, they are penalized if they provide care that's more prevention-oriented,” said Dr. Wilensky, who noted that a pay-for-performance-based system would reward those physicians. “This is in many ways a response to some of that criticism by physicians.”

Panel member Dr. Robert Galvin, director of global health care for General Electric Co., agreed.

“There is a substantial percentage of physicians who like these programs [and] who like the idea of working in teams and having their performance rewarded,” Dr. Galvin said. “There is already a culture shift going on.”

The full report is available at www.iom.edu

The U.S. Department of Health and Human Services should gradually replace Medicare's current payment system with a pay-for-performance system that would reward physicians and other providers for efficiency along with patient-centered, quality care, according to a report from the Institute of Medicine.

Pay-for-performance plans do not yet have an established track record of improving care, so IOM's report, “Rewarding Provider Performance: Aligning Incentives in Medicare,” urges a phased-in program that will evaluate pay-for-performance initiatives as they are implemented.

Pay-for-performance will help transform the Medicare payment system into one that rewards both higher value and better outcomes, Robert Reischauer, Ph.D., president of the Washington-based Urban Institute, said at a press briefing sponsored by IOM. Dr. Reischauer served on the committee that wrote the report.

“The committee does not feel that pay-for-performance is the magic bullet,” he said. “Pay-for-performance should be considered one of several key elements needed to restructure the current payment system.”

Any changes in Medicare's payment system would need to be approved by Congress. The panel's report urged lawmakers to adopt an initial system that would reduce base Medicare payments across the board and use the money to fund rewards for strong performance. At the same time, Medicare officials would evaluate the program to make certain it is having the desired effects.

The proportion of Medicare payment withheld would be small at first, and providers would be compensated both for excellent work and for improving their performance in areas that encompass care quality, efficiency, and “patient centeredness.”

“We are recommending a performance-based system in which both excellence is rewarded and significant improvement is rewarded,” Dr. Reischauer said. “Everyone can play and everyone can get back the money that was withheld initially from them.”

Many large health care providers and organizations already have the capacity to begin participating in a Medicare pay-for-performance system and should be required to do so as soon as it is launched, the IOM report said.

The U.S. Department of Health and Human Services should gradually replace Medicare's current payment system with a pay-for-performance system that would reward physicians and other providers for efficiency along with patient-centered, quality care, according to a report from the Institute of Medicine.

Pay-for-performance plans do not yet have an established track record of improving care, so IOM's report, “Rewarding Provider Performance: Aligning Incentives in Medicare,” urges a phased-in program that will evaluate pay-for-performance initiatives as they are implemented.

Pay-for-performance will help transform the Medicare payment system into one that rewards both higher value and better outcomes, Robert Reischauer, Ph.D., president of the Washington-based Urban Institute, said at a press briefing sponsored by IOM. Dr. Reischauer served on the committee that wrote the report.

“The committee does not feel that pay-for-performance is the magic bullet,” he said. “Pay-for-performance should be considered one of several key elements needed to restructure the current payment system.”

Any changes in Medicare's payment system would need to be approved by Congress. The panel's report urged lawmakers to adopt an initial system that would reduce base Medicare payments across the board and use the money to fund rewards for strong performance. At the same time, Medicare officials would evaluate the program to make certain it is having the desired effects.

The proportion of Medicare payment withheld would be small at first, and providers would be compensated both for excellent work and for improving their performance in areas that encompass care quality, efficiency, and “patient centeredness.”

“We are recommending a performance-based system in which both excellence is rewarded and significant improvement is rewarded,” Dr. Reischauer said. “Everyone can play and everyone can get back the money that was withheld initially from them.”

Many large health care providers and organizations already have the capacity to begin participating in a Medicare pay-for-performance system and should be required to do so as soon as it is launched, the IOM report said.

The U.S. Department of Health and Human Services should gradually replace Medicare's current payment system with a pay-for-performance system that would reward physicians and other providers for efficiency along with patient-centered, quality care, according to a report from the Institute of Medicine.

Pay-for-performance plans do not yet have an established track record of improving care, so IOM's report, “Rewarding Provider Performance: Aligning Incentives in Medicare,” urges a phased-in program that will evaluate pay-for-performance initiatives as they are implemented.

Pay-for-performance will help transform the Medicare payment system into one that rewards both higher value and better outcomes, Robert Reischauer, Ph.D., president of the Washington-based Urban Institute, said at a press briefing sponsored by IOM. Dr. Reischauer served on the committee that wrote the report.

“The committee does not feel that pay-for-performance is the magic bullet,” he said. “Pay-for-performance should be considered one of several key elements needed to restructure the current payment system.”

Any changes in Medicare's payment system would need to be approved by Congress. The panel's report urged lawmakers to adopt an initial system that would reduce base Medicare payments across the board and use the money to fund rewards for strong performance. At the same time, Medicare officials would evaluate the program to make certain it is having the desired effects.

The proportion of Medicare payment withheld would be small at first, and providers would be compensated both for excellent work and for improving their performance in areas that encompass care quality, efficiency, and “patient centeredness.”

“We are recommending a performance-based system in which both excellence is rewarded and significant improvement is rewarded,” Dr. Reischauer said. “Everyone can play and everyone can get back the money that was withheld initially from them.”

Many large health care providers and organizations already have the capacity to begin participating in a Medicare pay-for-performance system and should be required to do so as soon as it is launched, the IOM report said.

The U.S. Department of Health and Human Services should gradually replace Medicare's current payment system with a pay-for-performance system that would reward physicians and other providers for efficiency along with patient-centered, quality care, according to a report from the Institute of Medicine.

Pay-for-performance plans do not yet have an established track record of improving care, so IOM's report, “Rewarding Provider Performance: Aligning Incentives in Medicare,” urges a phased-in program that will evaluate pay-for-performance initiatives as they are implemented.

Pay-for-performance will help transform the Medicare payment system into one that rewards both higher value and better outcomes, Robert Reischauer, Ph.D., president of the Washington-based Urban Institute, said at a press briefing sponsored by IOM. Dr. Reischauer served on the committee that wrote the report.

“The committee does not feel that pay for performance is the magic bullet,” he said. “Pay for performance should be considered one of several key elements needed to restructure the current payment system.”

Any changes in Medicare's payment system would need to be approved by Congress. The panel's report urged lawmakers to adopt an initial system that would reduce base Medicare payments across the board and use the money to fund rewards for strong performance. At the same time, Medicare officials would evaluate the program to make certain it is having the desired effects.

The proportion of Medicare payment withheld would be small at first, and providers would be compensated both for excellent work and for improving their performance in areas that encompass care quality, efficiency, and “patient centeredness.”

“We are recommending a performance-based system in which both excellence is rewarded and significant improvement is rewarded,” Dr. Reischauer said. “Everyone can play and everyone can get back the money that was withheld initially from them.”

Many large health care providers and organizations already have the capacity to begin participating in a Medicare pay-for-performance system and should be required to do so as soon as it is launched, the IOM report said. However, participation by small physician practices should be voluntary for the first 3 years.

Gail Wilensky, Ph.D., a senior fellow at Project HOPE and a member of the IOM panel, said she would expect most physicians to welcome a new, pay-for-performance-based system.

“Many physicians have complained that, when participating in Medicare, they are penalized if they provide care that's more prevention-oriented,” said Dr. Wilensky, who noted that a pay-for-performance-based system would reward those physicians. “This is in many ways a response to some of that criticism by physicians.”

Panel member Dr. Robert Galvin, director of global health care for General Electric Co., agreed. “There is a substantial percentage of physicians who like these programs [and] who like the idea of working in teams and having their performance rewarded,” he said. “There is already a culture shift going on among a good group of physicians.”

Public reporting of quality results also would serve as a strong motivator for physicians and other providers to improve their results, Dr. Wilensky said.

The panel did not specify how much Medicare base payments should be decreased to create a pool of funds for bonus payments, but recommended that the percentage be sufficient to create rewards large enough to motivate health care providers' participation and real improvements.

Committee members acknowledged that Medicare physician fees are scheduled to decline over the next few years, and said that Congress may need to add some new money to physician payments to make sure that the reward pool is sufficient.

The full report is available at www.iom.edu

The U.S. Department of Health and Human Services should gradually replace Medicare's current payment system with a pay-for-performance system that would reward physicians and other providers for efficiency along with patient-centered, quality care, according to a report from the Institute of Medicine.

Pay-for-performance plans do not yet have an established track record of improving care, so IOM's report, “Rewarding Provider Performance: Aligning Incentives in Medicare,” urges a phased-in program that will evaluate pay-for-performance initiatives as they are implemented.

Pay-for-performance will help transform the Medicare payment system into one that rewards both higher value and better outcomes, Robert Reischauer, Ph.D., president of the Washington-based Urban Institute, said at a press briefing sponsored by IOM. Dr. Reischauer served on the committee that wrote the report.

“The committee does not feel that pay for performance is the magic bullet,” he said. “Pay for performance should be considered one of several key elements needed to restructure the current payment system.”

Any changes in Medicare's payment system would need to be approved by Congress. The panel's report urged lawmakers to adopt an initial system that would reduce base Medicare payments across the board and use the money to fund rewards for strong performance. At the same time, Medicare officials would evaluate the program to make certain it is having the desired effects.

The proportion of Medicare payment withheld would be small at first, and providers would be compensated both for excellent work and for improving their performance in areas that encompass care quality, efficiency, and “patient centeredness.”

“We are recommending a performance-based system in which both excellence is rewarded and significant improvement is rewarded,” Dr. Reischauer said. “Everyone can play and everyone can get back the money that was withheld initially from them.”

Many large health care providers and organizations already have the capacity to begin participating in a Medicare pay-for-performance system and should be required to do so as soon as it is launched, the IOM report said. However, participation by small physician practices should be voluntary for the first 3 years.

Gail Wilensky, Ph.D., a senior fellow at Project HOPE and a member of the IOM panel, said she would expect most physicians to welcome a new, pay-for-performance-based system.

“Many physicians have complained that, when participating in Medicare, they are penalized if they provide care that's more prevention-oriented,” said Dr. Wilensky, who noted that a pay-for-performance-based system would reward those physicians. “This is in many ways a response to some of that criticism by physicians.”

Panel member Dr. Robert Galvin, director of global health care for General Electric Co., agreed. “There is a substantial percentage of physicians who like these programs [and] who like the idea of working in teams and having their performance rewarded,” he said. “There is already a culture shift going on among a good group of physicians.”

Public reporting of quality results also would serve as a strong motivator for physicians and other providers to improve their results, Dr. Wilensky said.

The panel did not specify how much Medicare base payments should be decreased to create a pool of funds for bonus payments, but recommended that the percentage be sufficient to create rewards large enough to motivate health care providers' participation and real improvements.

Committee members acknowledged that Medicare physician fees are scheduled to decline over the next few years, and said that Congress may need to add some new money to physician payments to make sure that the reward pool is sufficient.

The full report is available at www.iom.edu

The U.S. Department of Health and Human Services should gradually replace Medicare's current payment system with a pay-for-performance system that would reward physicians and other providers for efficiency along with patient-centered, quality care, according to a report from the Institute of Medicine.

Pay-for-performance plans do not yet have an established track record of improving care, so IOM's report, “Rewarding Provider Performance: Aligning Incentives in Medicare,” urges a phased-in program that will evaluate pay-for-performance initiatives as they are implemented.

Pay-for-performance will help transform the Medicare payment system into one that rewards both higher value and better outcomes, Robert Reischauer, Ph.D., president of the Washington-based Urban Institute, said at a press briefing sponsored by IOM. Dr. Reischauer served on the committee that wrote the report.

“The committee does not feel that pay for performance is the magic bullet,” he said. “Pay for performance should be considered one of several key elements needed to restructure the current payment system.”

Any changes in Medicare's payment system would need to be approved by Congress. The panel's report urged lawmakers to adopt an initial system that would reduce base Medicare payments across the board and use the money to fund rewards for strong performance. At the same time, Medicare officials would evaluate the program to make certain it is having the desired effects.

The proportion of Medicare payment withheld would be small at first, and providers would be compensated both for excellent work and for improving their performance in areas that encompass care quality, efficiency, and “patient centeredness.”

“We are recommending a performance-based system in which both excellence is rewarded and significant improvement is rewarded,” Dr. Reischauer said. “Everyone can play and everyone can get back the money that was withheld initially from them.”

Many large health care providers and organizations already have the capacity to begin participating in a Medicare pay-for-performance system and should be required to do so as soon as it is launched, the IOM report said. However, participation by small physician practices should be voluntary for the first 3 years.

Gail Wilensky, Ph.D., a senior fellow at Project HOPE and a member of the IOM panel, said she would expect most physicians to welcome a new, pay-for-performance-based system.

“Many physicians have complained that, when participating in Medicare, they are penalized if they provide care that's more prevention-oriented,” said Dr. Wilensky, who noted that a pay-for-performance-based system would reward those physicians. “This is in many ways a response to some of that criticism by physicians.”

Panel member Dr. Robert Galvin, director of global health care for General Electric Co., agreed. “There is a substantial percentage of physicians who like these programs [and] who like the idea of working in teams and having their performance rewarded,” he said. “There is already a culture shift going on among a good group of physicians.”

Public reporting of quality results also would serve as a strong motivator for physicians and other providers to improve their results, Dr. Wilensky said.

The panel did not specify how much Medicare base payments should be decreased to create a pool of funds for bonus payments, but recommended that the percentage be sufficient to create rewards large enough to motivate health care providers' participation and real improvements.

Committee members acknowledged that Medicare physician fees are scheduled to decline over the next few years, and said that Congress may need to add some new money to physician payments to make sure that the reward pool is sufficient.

The full report is available at www.iom.edu

The U.S. Department of Health and Human Services should gradually replace Medicare's current payment system with a pay-for-performance system that would reward physicians and other providers for efficiency along with patient-centered, quality care, according to a report from the Institute of Medicine.

Pay-for-performance plans do not yet have an established track record of improving care, so IOM's report, “Rewarding Provider Performance: Aligning Incentives in Medicare,” urges a phased-in program that will evaluate pay-for-performance initiatives as they are implemented.

Pay for performance will help transform the Medicare payment system into one that rewards both higher value and better outcomes, Robert Reischauer, Ph.D., president of the Washington-based Urban Institute, said at a press briefing sponsored by IOM. Dr. Reischauer served on the committee that wrote the report.

“The committee does not feel that pay for performance is the magic bullet,” he said. “Pay for performance should be considered one of several key elements needed to restructure the current payment system.”

Any changes in Medicare's payment system would need Congressional approval.

The panel's report urged lawmakers to adopt an initial system that would reduce base Medicare payments across the board and use the money to fund rewards for strong performance. At the same time, Medicare officials would evaluate the program to make certain it is having the desired effects.

The proportion of Medicare payment withheld would be small at first, and providers would be compensated both for excellent work and for improving performance in areas that encompass care quality, efficiency, and “patient centeredness.”

“We are recommending a performance-based system in which both excellence is rewarded and significant improvement is rewarded,” Dr. Reischauer said. “Everyone can play and everyone can get back the money that was withheld initially from them.”

Many large health care providers and organizations could participate in a Medicare pay-for-performance system and should be required to do so as soon as it is launched, the IOM report said. But participation by small physician practices should be voluntary for the first 3 years.

Gail Wilensky, Ph.D., a senior fellow at Project HOPE and a member of the IOM panel, said most physicians would welcome a new, pay-for-performance-based system. “Many physicians have complained that, when participating in Medicare, they are penalized if they provide care that's more prevention-oriented,” said Dr. Wilensky, noting that a pay-for-performance-based system would reward those physicians. “This is in many ways a response to some of that criticism by physicians.”

Panel member Dr. Robert Galvin, director of global health care for General Electric Co., agreed. “There is a substantial percentage of physicians who like these programs [and] who like the idea of working in teams and having their performance rewarded,” he said. “There is already a culture shift going on among a good group of physicians.”

Public reporting of quality results also would serve as a strong motivator for physicians and other providers to improve their results, Dr. Wilensky said.

The panel did not specify how much Medicare base payments should be decreased to create a pool of funds for bonus payments, but said the percentage should be sufficient to create rewards large enough to motivate provider participation.

Members acknowledged that Medicare physician fees already are scheduled to decline over the next few years and said that Congress may need to add some new money to physician payments to make sure that the reward pool is sufficient.

The full report is available at www.iom.edu

Most physicians would welcome a new, pay-for-performance-based system. DR. WILENSKY

The U.S. Department of Health and Human Services should gradually replace Medicare's current payment system with a pay-for-performance system that would reward physicians and other providers for efficiency along with patient-centered, quality care, according to a report from the Institute of Medicine.

Pay-for-performance plans do not yet have an established track record of improving care, so IOM's report, “Rewarding Provider Performance: Aligning Incentives in Medicare,” urges a phased-in program that will evaluate pay-for-performance initiatives as they are implemented.

Pay for performance will help transform the Medicare payment system into one that rewards both higher value and better outcomes, Robert Reischauer, Ph.D., president of the Washington-based Urban Institute, said at a press briefing sponsored by IOM. Dr. Reischauer served on the committee that wrote the report.

“The committee does not feel that pay for performance is the magic bullet,” he said. “Pay for performance should be considered one of several key elements needed to restructure the current payment system.”

Any changes in Medicare's payment system would need Congressional approval.

The panel's report urged lawmakers to adopt an initial system that would reduce base Medicare payments across the board and use the money to fund rewards for strong performance. At the same time, Medicare officials would evaluate the program to make certain it is having the desired effects.

The proportion of Medicare payment withheld would be small at first, and providers would be compensated both for excellent work and for improving performance in areas that encompass care quality, efficiency, and “patient centeredness.”

“We are recommending a performance-based system in which both excellence is rewarded and significant improvement is rewarded,” Dr. Reischauer said. “Everyone can play and everyone can get back the money that was withheld initially from them.”

Many large health care providers and organizations could participate in a Medicare pay-for-performance system and should be required to do so as soon as it is launched, the IOM report said. But participation by small physician practices should be voluntary for the first 3 years.

Gail Wilensky, Ph.D., a senior fellow at Project HOPE and a member of the IOM panel, said most physicians would welcome a new, pay-for-performance-based system. “Many physicians have complained that, when participating in Medicare, they are penalized if they provide care that's more prevention-oriented,” said Dr. Wilensky, noting that a pay-for-performance-based system would reward those physicians. “This is in many ways a response to some of that criticism by physicians.”

Panel member Dr. Robert Galvin, director of global health care for General Electric Co., agreed. “There is a substantial percentage of physicians who like these programs [and] who like the idea of working in teams and having their performance rewarded,” he said. “There is already a culture shift going on among a good group of physicians.”

Public reporting of quality results also would serve as a strong motivator for physicians and other providers to improve their results, Dr. Wilensky said.

The panel did not specify how much Medicare base payments should be decreased to create a pool of funds for bonus payments, but said the percentage should be sufficient to create rewards large enough to motivate provider participation.

Members acknowledged that Medicare physician fees already are scheduled to decline over the next few years and said that Congress may need to add some new money to physician payments to make sure that the reward pool is sufficient.

The full report is available at www.iom.edu

Most physicians would welcome a new, pay-for-performance-based system. DR. WILENSKY

The U.S. Department of Health and Human Services should gradually replace Medicare's current payment system with a pay-for-performance system that would reward physicians and other providers for efficiency along with patient-centered, quality care, according to a report from the Institute of Medicine.

Pay-for-performance plans do not yet have an established track record of improving care, so IOM's report, “Rewarding Provider Performance: Aligning Incentives in Medicare,” urges a phased-in program that will evaluate pay-for-performance initiatives as they are implemented.

Pay for performance will help transform the Medicare payment system into one that rewards both higher value and better outcomes, Robert Reischauer, Ph.D., president of the Washington-based Urban Institute, said at a press briefing sponsored by IOM. Dr. Reischauer served on the committee that wrote the report.

“The committee does not feel that pay for performance is the magic bullet,” he said. “Pay for performance should be considered one of several key elements needed to restructure the current payment system.”

Any changes in Medicare's payment system would need Congressional approval.

The panel's report urged lawmakers to adopt an initial system that would reduce base Medicare payments across the board and use the money to fund rewards for strong performance. At the same time, Medicare officials would evaluate the program to make certain it is having the desired effects.

The proportion of Medicare payment withheld would be small at first, and providers would be compensated both for excellent work and for improving performance in areas that encompass care quality, efficiency, and “patient centeredness.”

“We are recommending a performance-based system in which both excellence is rewarded and significant improvement is rewarded,” Dr. Reischauer said. “Everyone can play and everyone can get back the money that was withheld initially from them.”

Many large health care providers and organizations could participate in a Medicare pay-for-performance system and should be required to do so as soon as it is launched, the IOM report said. But participation by small physician practices should be voluntary for the first 3 years.

Gail Wilensky, Ph.D., a senior fellow at Project HOPE and a member of the IOM panel, said most physicians would welcome a new, pay-for-performance-based system. “Many physicians have complained that, when participating in Medicare, they are penalized if they provide care that's more prevention-oriented,” said Dr. Wilensky, noting that a pay-for-performance-based system would reward those physicians. “This is in many ways a response to some of that criticism by physicians.”

Panel member Dr. Robert Galvin, director of global health care for General Electric Co., agreed. “There is a substantial percentage of physicians who like these programs [and] who like the idea of working in teams and having their performance rewarded,” he said. “There is already a culture shift going on among a good group of physicians.”

Public reporting of quality results also would serve as a strong motivator for physicians and other providers to improve their results, Dr. Wilensky said.

The panel did not specify how much Medicare base payments should be decreased to create a pool of funds for bonus payments, but said the percentage should be sufficient to create rewards large enough to motivate provider participation.

Members acknowledged that Medicare physician fees already are scheduled to decline over the next few years and said that Congress may need to add some new money to physician payments to make sure that the reward pool is sufficient.

The full report is available at www.iom.edu

Most physicians would welcome a new, pay-for-performance-based system. DR. WILENSKY

The U.S. Department of Health and Human Services should gradually replace Medicare's current payment system with a pay-for-performance system that would reward physicians and other providers for efficiency along with patient-centered, quality care, according to a report from the Institute of Medicine.

Pay-for-performance plans do not yet have an established track record of improving care, so IOM's report, "Rewarding Provider Performance: Aligning Incentives in Medicare," urges a phased-in program that will evaluate pay-for-performance initiatives as they are implemented.

Pay-for-performance will help transform the Medicare payment system into one that rewards both higher value and better outcomes, Robert Reischauer, Ph.D., president of the Washington-based Urban Institute, said at a press briefing sponsored by IOM. Dr. Reischauer served on the committee that wrote the report.

"The committee does not feel that pay for performance is the magic bullet," he said. "Pay for performance should be considered one of several key elements needed to restructure the current payment system." Any changes in Medicare's payment system would need to be approved by Congress.

The panel's report urged lawmakers to adopt an initial system that would reduce base Medicare payments across the board and use the money to fund rewards for strong performance. At the same time, Medicare officials would evaluate the program to make certain it is having the desired effects.

The proportion of Medicare payment withheld would be small at first, and providers would be compensated both for excellent work and for improving their performance in areas that encompass care quality, efficiency, and "patient centeredness."

"We are recommending a performance-based system in which excellence and significant improvement [are both] rewarded," Dr. Reischauer said. "Everyone can play and everyone can get back the money that was withheld initially from them."

Many large health care providers and organizations already have the capacity to begin participating in a Medicare pay-for-performance system and should be required to do so as soon as it is launched, the IOM report said. However, participation by small physician practices should be voluntary for the first 3 years.

Gail Wilensky, Ph.D., a senior fellow at Project HOPE and a member of the IOM panel, said she would expect most physicians to welcome a new, pay-for-performance-based system.

"Many physicians have complained that, when participating in Medicare, they are penalized if they provide care that's more prevention oriented," said Dr. Wilensky, who noted that a pay-for-performance-based system would reward those physicians. "This is in many ways a response to some of that criticism by physicians."

Panel member Dr. Robert Galvin, director of global health care for General Electric Co., agreed. "There is a substantial percentage of physicians who like these programs [and] who like the idea of working in teams and having their performance rewarded," Dr. Galvin said. "There is already a culture shift going on among a good group of physicians."

Public reporting of quality results also would serve as a strong motivator for physicians and other providers to improve their results, Dr. Wilensky said.

The IOM panel did not specify how much Medicare base payments should be decreased to create a pool of funds for bonus payments, but recommended that the percentage be sufficient to create rewards large enough to motivate health care providers' participation and real improvements.

Committee members acknowledged that Medicare physician fees already are scheduled to decline over the next few years, and said that Congress may need to add some new money to physician payments to ensure that the reward pool is sufficient.

The full report is available at www.iom.edu

The U.S. Department of Health and Human Services should gradually replace Medicare's current payment system with a pay-for-performance system that would reward physicians and other providers for efficiency along with patient-centered, quality care, according to a report from the Institute of Medicine.

Pay-for-performance plans do not yet have an established track record of improving care, so IOM's report, "Rewarding Provider Performance: Aligning Incentives in Medicare," urges a phased-in program that will evaluate pay-for-performance initiatives as they are implemented.

Pay-for-performance will help transform the Medicare payment system into one that rewards both higher value and better outcomes, Robert Reischauer, Ph.D., president of the Washington-based Urban Institute, said at a press briefing sponsored by IOM. Dr. Reischauer served on the committee that wrote the report.

"The committee does not feel that pay for performance is the magic bullet," he said. "Pay for performance should be considered one of several key elements needed to restructure the current payment system." Any changes in Medicare's payment system would need to be approved by Congress.

The panel's report urged lawmakers to adopt an initial system that would reduce base Medicare payments across the board and use the money to fund rewards for strong performance. At the same time, Medicare officials would evaluate the program to make certain it is having the desired effects.

The proportion of Medicare payment withheld would be small at first, and providers would be compensated both for excellent work and for improving their performance in areas that encompass care quality, efficiency, and "patient centeredness."

"We are recommending a performance-based system in which excellence and significant improvement [are both] rewarded," Dr. Reischauer said. "Everyone can play and everyone can get back the money that was withheld initially from them."

Many large health care providers and organizations already have the capacity to begin participating in a Medicare pay-for-performance system and should be required to do so as soon as it is launched, the IOM report said. However, participation by small physician practices should be voluntary for the first 3 years.

Gail Wilensky, Ph.D., a senior fellow at Project HOPE and a member of the IOM panel, said she would expect most physicians to welcome a new, pay-for-performance-based system.

"Many physicians have complained that, when participating in Medicare, they are penalized if they provide care that's more prevention oriented," said Dr. Wilensky, who noted that a pay-for-performance-based system would reward those physicians. "This is in many ways a response to some of that criticism by physicians."

Panel member Dr. Robert Galvin, director of global health care for General Electric Co., agreed. "There is a substantial percentage of physicians who like these programs [and] who like the idea of working in teams and having their performance rewarded," Dr. Galvin said. "There is already a culture shift going on among a good group of physicians."

Public reporting of quality results also would serve as a strong motivator for physicians and other providers to improve their results, Dr. Wilensky said.

The IOM panel did not specify how much Medicare base payments should be decreased to create a pool of funds for bonus payments, but recommended that the percentage be sufficient to create rewards large enough to motivate health care providers' participation and real improvements.

Committee members acknowledged that Medicare physician fees already are scheduled to decline over the next few years, and said that Congress may need to add some new money to physician payments to ensure that the reward pool is sufficient.

The full report is available at www.iom.edu

The U.S. Department of Health and Human Services should gradually replace Medicare's current payment system with a pay-for-performance system that would reward physicians and other providers for efficiency along with patient-centered, quality care, according to a report from the Institute of Medicine.

Pay-for-performance plans do not yet have an established track record of improving care, so IOM's report, "Rewarding Provider Performance: Aligning Incentives in Medicare," urges a phased-in program that will evaluate pay-for-performance initiatives as they are implemented.

Pay-for-performance will help transform the Medicare payment system into one that rewards both higher value and better outcomes, Robert Reischauer, Ph.D., president of the Washington-based Urban Institute, said at a press briefing sponsored by IOM. Dr. Reischauer served on the committee that wrote the report.

"The committee does not feel that pay for performance is the magic bullet," he said. "Pay for performance should be considered one of several key elements needed to restructure the current payment system." Any changes in Medicare's payment system would need to be approved by Congress.

The panel's report urged lawmakers to adopt an initial system that would reduce base Medicare payments across the board and use the money to fund rewards for strong performance. At the same time, Medicare officials would evaluate the program to make certain it is having the desired effects.

The proportion of Medicare payment withheld would be small at first, and providers would be compensated both for excellent work and for improving their performance in areas that encompass care quality, efficiency, and "patient centeredness."

"We are recommending a performance-based system in which excellence and significant improvement [are both] rewarded," Dr. Reischauer said. "Everyone can play and everyone can get back the money that was withheld initially from them."

Many large health care providers and organizations already have the capacity to begin participating in a Medicare pay-for-performance system and should be required to do so as soon as it is launched, the IOM report said. However, participation by small physician practices should be voluntary for the first 3 years.

Gail Wilensky, Ph.D., a senior fellow at Project HOPE and a member of the IOM panel, said she would expect most physicians to welcome a new, pay-for-performance-based system.

"Many physicians have complained that, when participating in Medicare, they are penalized if they provide care that's more prevention oriented," said Dr. Wilensky, who noted that a pay-for-performance-based system would reward those physicians. "This is in many ways a response to some of that criticism by physicians."

Panel member Dr. Robert Galvin, director of global health care for General Electric Co., agreed. "There is a substantial percentage of physicians who like these programs [and] who like the idea of working in teams and having their performance rewarded," Dr. Galvin said. "There is already a culture shift going on among a good group of physicians."

Public reporting of quality results also would serve as a strong motivator for physicians and other providers to improve their results, Dr. Wilensky said.

The IOM panel did not specify how much Medicare base payments should be decreased to create a pool of funds for bonus payments, but recommended that the percentage be sufficient to create rewards large enough to motivate health care providers' participation and real improvements.

Committee members acknowledged that Medicare physician fees already are scheduled to decline over the next few years, and said that Congress may need to add some new money to physician payments to ensure that the reward pool is sufficient.

The full report is available at www.iom.edu

Despite some success stories, efforts to combat childhood obesity remain fragmented, and the policies and programs that are in place are not being evaluated, making it difficult to identify what works, according to a new report from the Institute of Medicine.

The federal government has failed to take the lead on tackling the issue, said the report, “Progress in Preventing Childhood Obesity: How Do We Measure Up?”

“There has been progress, but it's not enough, it's not fast enough, and it hasn't been taken to scale,” said Dr. Jeffrey Koplan, vice president for academic health affairs at Emory University in Atlanta, who chaired the IOM committee that wrote the report.

The document, a follow-up to a 2005 report on the same topic, was designed to assess progress in childhood obesity prevention. It finds that national awareness has increased and that short-term objectives are being achieved—for example, some school districts are restricting availability of sweetened soft drinks, and communities have built bike paths to encourage physical activity.

But these efforts aren't enough to turn around a multifaceted public health problem that took decades to develop, panel members said.

Currently, one-third of American children and youth are either obese or at risk for obesity. Over the past 30 years, the obesity rate nearly has tripled for children aged 2–5 years (from 5% to 14%) and youth aged 12–19 years (5% to 17%), and nearly has quadrupled for children ages 6–11 years (from 4% to 19%).

Despite efforts to improve nutrition and increase physical activity on the local level, few if any of these initiatives are being evaluated for efficacy, said the report. Federal, state, and local governments should ensure that such evaluation takes place, the committee members said.

The members called on families and caregivers to commit to promoting healthful eating and regular physical activity, and on governments at all levels to mobilize resources, both by convening high-level task forces to identify priorities and coordinate efforts and by sustaining successful programs.

That's where the federal government has lapsed, Dr. Koplan said. The IOM report highlighted the VERB: It's What You Do campaign, a successful effort sponsored by the Centers for Disease Control and Prevention, which ended in September because of a lack of funding.

Study findings have shown that the campaign, launched in 2002, was successful in raising awareness of its pro-physical activity message among children aged 9–13 years. Higher awareness of VERB was associated with higher free-time physical activity levels, according to the findings (Pediatrics 2005;116:e277–84).

But the VERB campaign, which received $36 million in 2004 and $59 million in 2005, was not included in the 2006 federal budget.

“This is something there should be outrage over,” said Dr. Koplan. “This campaign was able to get children and youth to get more physical activity. It was found to be effective. If we had a vaccine that worked and we put it on a shelf, people would be outraged over it.”

The panel called for the program to be reinstated.

It also highlighted professional organizations that actively promote obesity prevention.

For example, the committee found that physicians who hold public office often are proponents of obesity prevention measures, and groups such as the American Academy of Family Physicians and the American Academy of Pediatrics offer tools for preventing and managing obesity. In addition, major health plans increasingly are emphasizing obesity prevention for children and youth.

Despite some success stories, efforts to combat childhood obesity remain fragmented, and the policies and programs that are in place are not being evaluated, making it difficult to identify what works, according to a new report from the Institute of Medicine.

The federal government has failed to take the lead on tackling the issue, said the report, “Progress in Preventing Childhood Obesity: How Do We Measure Up?”

“There has been progress, but it's not enough, it's not fast enough, and it hasn't been taken to scale,” said Dr. Jeffrey Koplan, vice president for academic health affairs at Emory University in Atlanta, who chaired the IOM committee that wrote the report.

The document, a follow-up to a 2005 report on the same topic, was designed to assess progress in childhood obesity prevention. It finds that national awareness has increased and that short-term objectives are being achieved—for example, some school districts are restricting availability of sweetened soft drinks, and communities have built bike paths to encourage physical activity.

But these efforts aren't enough to turn around a multifaceted public health problem that took decades to develop, panel members said.

Currently, one-third of American children and youth are either obese or at risk for obesity. Over the past 30 years, the obesity rate nearly has tripled for children aged 2–5 years (from 5% to 14%) and youth aged 12–19 years (5% to 17%), and nearly has quadrupled for children ages 6–11 years (from 4% to 19%).

Despite efforts to improve nutrition and increase physical activity on the local level, few if any of these initiatives are being evaluated for efficacy, said the report. Federal, state, and local governments should ensure that such evaluation takes place, the committee members said.

The members called on families and caregivers to commit to promoting healthful eating and regular physical activity, and on governments at all levels to mobilize resources, both by convening high-level task forces to identify priorities and coordinate efforts and by sustaining successful programs.

That's where the federal government has lapsed, Dr. Koplan said. The IOM report highlighted the VERB: It's What You Do campaign, a successful effort sponsored by the Centers for Disease Control and Prevention, which ended in September because of a lack of funding.

Study findings have shown that the campaign, launched in 2002, was successful in raising awareness of its pro-physical activity message among children aged 9–13 years. Higher awareness of VERB was associated with higher free-time physical activity levels, according to the findings (Pediatrics 2005;116:e277–84).

But the VERB campaign, which received $36 million in 2004 and $59 million in 2005, was not included in the 2006 federal budget.

“This is something there should be outrage over,” said Dr. Koplan. “This campaign was able to get children and youth to get more physical activity. It was found to be effective. If we had a vaccine that worked and we put it on a shelf, people would be outraged over it.”

The panel called for the program to be reinstated.

It also highlighted professional organizations that actively promote obesity prevention.

For example, the committee found that physicians who hold public office often are proponents of obesity prevention measures, and groups such as the American Academy of Family Physicians and the American Academy of Pediatrics offer tools for preventing and managing obesity. In addition, major health plans increasingly are emphasizing obesity prevention for children and youth.

Despite some success stories, efforts to combat childhood obesity remain fragmented, and the policies and programs that are in place are not being evaluated, making it difficult to identify what works, according to a new report from the Institute of Medicine.

The federal government has failed to take the lead on tackling the issue, said the report, “Progress in Preventing Childhood Obesity: How Do We Measure Up?”

“There has been progress, but it's not enough, it's not fast enough, and it hasn't been taken to scale,” said Dr. Jeffrey Koplan, vice president for academic health affairs at Emory University in Atlanta, who chaired the IOM committee that wrote the report.

The document, a follow-up to a 2005 report on the same topic, was designed to assess progress in childhood obesity prevention. It finds that national awareness has increased and that short-term objectives are being achieved—for example, some school districts are restricting availability of sweetened soft drinks, and communities have built bike paths to encourage physical activity.

But these efforts aren't enough to turn around a multifaceted public health problem that took decades to develop, panel members said.

Currently, one-third of American children and youth are either obese or at risk for obesity. Over the past 30 years, the obesity rate nearly has tripled for children aged 2–5 years (from 5% to 14%) and youth aged 12–19 years (5% to 17%), and nearly has quadrupled for children ages 6–11 years (from 4% to 19%).

Despite efforts to improve nutrition and increase physical activity on the local level, few if any of these initiatives are being evaluated for efficacy, said the report. Federal, state, and local governments should ensure that such evaluation takes place, the committee members said.

The members called on families and caregivers to commit to promoting healthful eating and regular physical activity, and on governments at all levels to mobilize resources, both by convening high-level task forces to identify priorities and coordinate efforts and by sustaining successful programs.

That's where the federal government has lapsed, Dr. Koplan said. The IOM report highlighted the VERB: It's What You Do campaign, a successful effort sponsored by the Centers for Disease Control and Prevention, which ended in September because of a lack of funding.

Study findings have shown that the campaign, launched in 2002, was successful in raising awareness of its pro-physical activity message among children aged 9–13 years. Higher awareness of VERB was associated with higher free-time physical activity levels, according to the findings (Pediatrics 2005;116:e277–84).

But the VERB campaign, which received $36 million in 2004 and $59 million in 2005, was not included in the 2006 federal budget.

“This is something there should be outrage over,” said Dr. Koplan. “This campaign was able to get children and youth to get more physical activity. It was found to be effective. If we had a vaccine that worked and we put it on a shelf, people would be outraged over it.”

The panel called for the program to be reinstated.

It also highlighted professional organizations that actively promote obesity prevention.

For example, the committee found that physicians who hold public office often are proponents of obesity prevention measures, and groups such as the American Academy of Family Physicians and the American Academy of Pediatrics offer tools for preventing and managing obesity. In addition, major health plans increasingly are emphasizing obesity prevention for children and youth.