ACP issues policy paper on performance measures for low-value tests, treatments

Evidence-based performance measures for low-value tests and treatments can help physicians provide high-value care, according to a new policy paper from ACP.

The paper discusses two categories of low-quality interventions: those in which harms exceed benefits, and those with an undesirable tradeoff between benefits and expenditures, as determined by a multi-stakeholder group after quantitative assessment.

Types of measures that can be used to evaluate these interventions include direct measures, which judge whether an intervention was of low value based on each patient's unique clinical circumstances, and indirect measures, which evaluate utilization rates, the paper said. The paper also discusses the evidence base for creating performance measures for low-value services, individual versus group-level performance measurement, and applying performance measures to improve value.

“The first step in addressing the high cost of health care should be decreasing use of interventions that provide no or very little benefit and are of low value,” the paper said. “Performance measures for low-value care need to be developed and tested with the same rigorous methods as for performance measures for underuse of services; however, the evidence based used to develop measures will differ substantially. Evidence-based performance measures for low-value services can help motivate physicians to provide high-value care to their patients.”

The policy paper was published Oct. 30 by Annals of Internal Medicine and is available online.