Improving colonoscopy quality through health-care payment reform

David G. Hewett, Douglas Rex

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Problems with the quality of colonoscopy are well recognized. Variation in colonoscopist performance is compounded by payment structures that reward volume rather than quality. Payment reform has emerged as one strategy to address these and more systemic problems in the quality of health care. Various forms of value-based purchasing might encourage a realignment of incentives, and allow reimbursement to be directly linked with clinically important goals of colonoscopy. This paper proposes criteria for the selection of quality measures, and three candidate indicators to define quality for the purpose of payment reform in colonoscopy: cecal intubation rate, adenoma detection rate, and recommended post-polypectomy surveillance interval. These measures represent valid, credible, and reliable indicators of the quality of colonoscopy for colorectal cancer screening and surveillance. Payment reform should explicitly link public reporting and performance on these quality measures to payment for colonoscopy.

Original languageEnglish
Pages (from-to)1925-1933
Number of pages9
JournalAmerican Journal of Gastroenterology
Volume105
Issue number9
DOIs
StatePublished - Sep 2010

Fingerprint

Health Care Reform
Quality of Health Care
Colonoscopy
Value-Based Purchasing
Incentive Reimbursement
Reward
Early Detection of Cancer
Intubation
Adenoma
Patient Selection
Colorectal Neoplasms

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

Cite this

Improving colonoscopy quality through health-care payment reform. / Hewett, David G.; Rex, Douglas.

In: American Journal of Gastroenterology, Vol. 105, No. 9, 09.2010, p. 1925-1933.

Research output: Contribution to journalArticle

Hewett, David G. ; Rex, Douglas. / Improving colonoscopy quality through health-care payment reform. In: American Journal of Gastroenterology. 2010 ; Vol. 105, No. 9. pp. 1925-1933.
@article{dd941d2efce64dba960a18ea652c12c6,
title = "Improving colonoscopy quality through health-care payment reform",
abstract = "Problems with the quality of colonoscopy are well recognized. Variation in colonoscopist performance is compounded by payment structures that reward volume rather than quality. Payment reform has emerged as one strategy to address these and more systemic problems in the quality of health care. Various forms of value-based purchasing might encourage a realignment of incentives, and allow reimbursement to be directly linked with clinically important goals of colonoscopy. This paper proposes criteria for the selection of quality measures, and three candidate indicators to define quality for the purpose of payment reform in colonoscopy: cecal intubation rate, adenoma detection rate, and recommended post-polypectomy surveillance interval. These measures represent valid, credible, and reliable indicators of the quality of colonoscopy for colorectal cancer screening and surveillance. Payment reform should explicitly link public reporting and performance on these quality measures to payment for colonoscopy.",
author = "Hewett, {David G.} and Douglas Rex",
year = "2010",
month = "9",
doi = "10.1038/ajg.2010.247",
language = "English",
volume = "105",
pages = "1925--1933",
journal = "American Journal of Gastroenterology",
issn = "0002-9270",
publisher = "Nature Publishing Group",
number = "9",

}

TY - JOUR

T1 - Improving colonoscopy quality through health-care payment reform

AU - Hewett, David G.

AU - Rex, Douglas

PY - 2010/9

Y1 - 2010/9

N2 - Problems with the quality of colonoscopy are well recognized. Variation in colonoscopist performance is compounded by payment structures that reward volume rather than quality. Payment reform has emerged as one strategy to address these and more systemic problems in the quality of health care. Various forms of value-based purchasing might encourage a realignment of incentives, and allow reimbursement to be directly linked with clinically important goals of colonoscopy. This paper proposes criteria for the selection of quality measures, and three candidate indicators to define quality for the purpose of payment reform in colonoscopy: cecal intubation rate, adenoma detection rate, and recommended post-polypectomy surveillance interval. These measures represent valid, credible, and reliable indicators of the quality of colonoscopy for colorectal cancer screening and surveillance. Payment reform should explicitly link public reporting and performance on these quality measures to payment for colonoscopy.

AB - Problems with the quality of colonoscopy are well recognized. Variation in colonoscopist performance is compounded by payment structures that reward volume rather than quality. Payment reform has emerged as one strategy to address these and more systemic problems in the quality of health care. Various forms of value-based purchasing might encourage a realignment of incentives, and allow reimbursement to be directly linked with clinically important goals of colonoscopy. This paper proposes criteria for the selection of quality measures, and three candidate indicators to define quality for the purpose of payment reform in colonoscopy: cecal intubation rate, adenoma detection rate, and recommended post-polypectomy surveillance interval. These measures represent valid, credible, and reliable indicators of the quality of colonoscopy for colorectal cancer screening and surveillance. Payment reform should explicitly link public reporting and performance on these quality measures to payment for colonoscopy.

UR - http://www.scopus.com/inward/record.url?scp=77956343506&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77956343506&partnerID=8YFLogxK

U2 - 10.1038/ajg.2010.247

DO - 10.1038/ajg.2010.247

M3 - Article

C2 - 20551937

AN - SCOPUS:77956343506

VL - 105

SP - 1925

EP - 1933

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

SN - 0002-9270

IS - 9

ER -