title: Reporting of quality measures in gynecologic oncology programs at Prospective Payment System (PPS)-Exempt Cancer Hospitals: an early glimpse into a challenging initiative.
abstract: OBJECTIVE
  The Affordable Care Act mandates the Prospective Payment System (PPS)-Exempt Cancer Hospitals Quality Reporting program. These 11 hospitals (which are paid fee-for-service rather than on a DRG system) began reporting measures (2 general safety, 2 breast, 1 colon) in 2013. Given this reporting mandate, we set out to determine whether the PPS-exempt gynecologic oncology programs could identify quality measures specific to the care of our patients.
  
  
  METHODS
  A list of 12 quality measures specific to gynecologic oncology was created (from sources including the National Quality Forum and the SGO). Measures already in use were not included. The list was ranked by the gynecologic oncology program directors at the PPS-exempt hospitals. Descriptive statistics (including mean and SD for rankings) were utilized.
  
  
  RESULTS
  Despite mandatory reporting of quality measures for PPS-exempt cancer hospitals, little consensus exists regarding specific gynecologic cancer measures. Documentation of debulking status, cancer survival, and offering minimally invasive surgery (for endometrial cancer) and intraperitoneal chemotherapy (for ovarian cancer) are important, but with widely variable responses (when ranked 1-12, standard deviations are 2-3). General issues regarding adherence to guidelines for the use of GCSF, documentation of functional status, and tracking of patient satisfaction scores were ranked the lowest. Three of the directors reported that their compensation is partially linked to quality outcomes.
  
  
  CONCLUSIONS
  There is wide variability in ranking of quality measures, and may relate to provider or institutional factors. Despite the mandatory reporting in PPS-exempt cancer hospitals, work remains to define gynecologic cancer quality measures.
authors.affiliation: The Ohio State University, Columbus, OH, USA. David.Cohn@osumc.edu
authors.forename: David E
authors.initials: DE
authors.lastname: Cohn
authors.forename: Mario
authors.initials: M
authors.lastname: Leitao
authors.forename: Charles
authors.initials: C
authors.lastname: Levenback
authors.forename: Ross
authors.initials: R
authors.lastname: Berkowitz
authors.forename: Lynda
authors.initials: L
authors.lastname: Roman
authors.forename: Joseph
authors.initials: J
authors.lastname: Lucci
authors.forename: Sarah
authors.initials: S
authors.lastname: Kim
authors.forename: Johnathon
authors.initials: J
authors.lastname: Lancaster
authors.forename: Kunle
authors.initials: K
authors.lastname: Odunsi
authors.forename: Mark
authors.initials: M
authors.lastname: Wakabayashi
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Goff
mesh_terms: D003625:Data Collection; D018588:Fee-for-Service Plans; D005260:Female; D005833:Genital Neoplasms, Female / Q000175:diagnosis* / Q000628:therapy*; D006176:Gynecology / Q000592:standards*; D006782:Hospitals, Special / Q000191:economics / Q000331:legislation & jurisprudence; D006801:Humans; D019221:Mandatory Reporting; D008495:Medical Oncology / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care; D058991:Patient Protection and Affordable Care Act; D019984:Quality Indicators, Health Care; D014481:United States
keywords: Affordable Care Act; PPS-exempt; Quality measures