The subtitle of this article might be, what performance measures should employers be tracking and paying for in ambulatory care
The article was passed to me by Sophia Chang, MD, at the California Healthcare Foundation, who has been advising and supporting on our Connectivity for Californians work, and is a nice economic study of 62 performance measures used in specialty recertifcation program and pay-for-performance initiatives.
The measures will look familiar to anyone who works in quality improvement - everything from blood pressure management, to retinal eye screening, all the way through to some measures that have less data associated with them, such as plan of care for hypertension. What the authors did was grade the evidence of effectiveness, add cost and benefit data based on meta-analyses and derive a savings per patient for each measure.
There are a few critical assumptions made, including full adherence to therapy (they used the term which is no longer recommended), and most importantly, no quantification of indirect costs. In other words, this is not a study of presenteeism, only direct medical costs.
What came out near the top of measures with the most impressive savings profile? Hypertension management.

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