Crossing the Quality Chasm -- Balancing cost and quality care requires thoughtful examination, especially in a discipline like oncology

During my presidency (1999-2000), the American Society of Clinical Oncology (ASCO) launched its groundbreaking study-the National Initiative on Cancer Care Quality (NICCQ). One of the purposes of the NICCQ was to measure and report on the quality of cancer care and to obtain results that inform quality improvement efforts. Gathering the data was a daunting task, but the researchers were able to harvest complete medical records for nearly 50% of the eligible patients. It's worth noting that the NICCQ was the first study of its size to look at the viability of obtaining all of the patient's medical records, not only from the oncologist, but also the primary care physician. Linking validated quality care to payment has moved from a relatively obscure theory to reality. Congress has embraced this issue, seeing an opportunity to enhance quality and save valuable health-care dollars. At the end of 2006, legislation was passed that included certain bonus payments for reporting of quality care measures. Fortunately, ASCO has been ahead of the curve on this issue. In fact, over the past year ASCO and the National Comprehensive Cancer Network (NCCN) have worked to interdigitate the NICCQ's validated quality measures with NCCN practice guidelines. We've formally submitted these quality measures to the Centers for Medicare and Medicaid Services (CMS) and we hope this concerted effort will form the basis for the quality reporting that Congress has mandated.