Quality Measurement in Oncology: Time to Take the Next Step!

Oncology is a complex clinical specialty often requiring the close interaction of teams of different medical specialists for a successful outcome. The field is rapidly evolving scientifically, with successive discoveries of oncologic driver mutations soon followed by therapeutic agents able to interrupt the neoplastic process. Unfortunately, objective quality measurement demonstrates that many patients are not receiving optimal care, from diagnostic accuracy, therapeutic, or end-of-life perspectives. Quality measurement, reporting, and payment programs have the potential to focus attention on these care gaps and drive improvement. The federal government, as the largest single payer of health care services in the United States, has a compelling national interest to ensure that the medical care of Americans is at the highest level achievable. Accordingly, quality reporting and payment programs have been established in federal health care payment programs to drive improvements in care. This article reviews the science of quality measurement, documented gaps in oncology care, and ways to use new information technologies to decrease clinician burden associated with quality reporting. The article reviews how a measure is developed and incorporated into a Centers for Medicare & Medicaid Services (CMS) program. It also summarizes federal programs relevant to oncology care and the individual measures used in these programs. CMS looks forward to working jointly with the oncology community to drive continuous improvements in care.