753: Quality and feasibility of obstetrics and gynecology performance metrics

Performance measures are widely used in healthcare, ranging from quality reporting, accountability, payment and monitoring of physicians and organizations. We sought to assess the validity and evidence for the Medicare Merit- based Incentive Payment System (MIPS) measures for obstetrics and gynecology. Using MIPS measures, we reviewed the 46 OB/GYN measures. A group of 4 obstetrician-gynecologists and maternal fetal medicine physicians assessed the validity of the metrics for importance, appropriate care, clinical evidence, specifications and feasibility. Measures were assessed using a 9-point scale (1-3 does not meet criteria; 4-6 meets some criteria; 7-9 meets criteria). Median scores were calculated, with measures considered valid with median rating of 7-9, not valid with median rating of 1-3, and 4-6 was uncertain. Microsoft Excel was used for analysis. The percentage of measures rated as uncertain validity was 43% (n=20), with 56% rated as valid and no measures rated as non-valid. Valid measures had a range scores from 7-8.5, while measures of uncertain validity had a range of scores from 4.5-6.5. A higher percentage of measures endorsed by the national quality foundation (NQF) were considered valid (62%) compared to non-NQF endorsed measures (52%). When comparing measures, 19% (5/26) of those rated as valid had uncertain clinical evidence, while 100% (20/20) of those with uncertain validity had uncertain clinical evidence. Seventeen measures (37%) were of uncertain feasibility. A high percentage of OB/GYN quality measures were judged to be of uncertain validity. Quality measures should be further evaluated to ensure meaningful improvements in patient care and validity.