TABLE C-4 Ambulatory care Quality Alliance

Design Issues

Ambulatory care Quality Alliance (AQA)a

Participation (Voluntary/Mandatory)

Voluntary.

Unit of Accountability

Physicians and physician groups.

Improvement/Excellence

Not applicable.

Weighting

Alignment or linkage of quality and cost of care measures.

Rewards/Penalties

Not applicable.

Absolute or Tournament

Not applicable.

Payment

Not applicable.

Funding

Not applicable.

Phasing

No discussion to date.

Measure Development and Selection

AQA does not develop measures; it approves measures developed by National Committee for Quality Assurance, Joint Commission on Accreditation of Healthcare Organizations, American Medical Association PCPI, and other medical specialty organizations that meet AQA-defined parameters.

Administrative vs. Chart Data

Implementation of measures should be as least burdensome as possible. While the AQA Performance Measurement Workgroup acknowledges that administrative data should be considered as the logical starting point, there is interest in moving beyond claims and other administrative data as soon as is practicable. As appropriate, measures derived from medical chart review should not be excluded.

Care Coordination

Not applicable.

aThe AQA does not specifically address or take a position on pay-for-performance programs; rather, its work focuses on evidence-based, valid, reliable performance measures for quality improvement and accountability. AQA encourages implementation of standardized performance measures endorsed by AQA for physician assessment, one component of which may be pay-for-performance programs.



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