President's Update, August 2016

Antonio C. Bianco, MD, PhD ATA President

Dear Colleagues,

I am thrilled with the successful preparations of our 86th Annual Meeting, and certainly looking forward to seeing you all in Denver Colorado.

Through the years the ATA has maintained its leadership by a number of educational, research and clinical initiatives showcased in our publications and annual meeting. A major piece of this effort relies on developing clinical guidelines. This is the moment in which experts separate fact from fiction by scrutinizing to a great level of detail all relevant studies, and make recommendations based on, as much as possible, unbiased data. It is of course expected that clinical outcomes will improve by understanding the limits of our knowledge and following these well thought recommendations. How this is assessed and what defines success in our own practices is our next frontier.

The Centers for Medicare and Medicaid and multiple non-governmental organizations are now rewarding health care providers with incentive payments for the quality of care they give to patients. Multiple programs exist and they all have in common the need to define appropriate success, quality metrics. At the Federal level, MACRA and the Merit-based Incentive Payment System (MIPS) pathway is the legislation that equates payments to clinicians with the value and quality of care they provide. Hundreds of quality metrics exist. For example, blood pressure is used to assess effectiveness of treatment of hypertension, HbA1C levels are used to assess treatment of diabetes. Thus, payments to clinicians managing these conditions can be positively or negatively affected based on these very specific quality metrics. Should we as an organization be thinking about quality metrics to assess effectiveness of treatment of patients with thyroid disease?

I would argue that as a group we should lead the effort to define what the highest quality of care for a thyroid patient is. In other medical specialties, professional societies have created registries where participants submit quality data, e.g. compliance with nationally accepted guidelines, complications or mortality, on a regular basis. As a result organizations can be benchmarked against all participants nationwide. A number of these registries are evaluated by the National Quality Forum (NQF) and utilized to create consensus standards that can be included as a metric in the MIPS pathway.

Let us take a moment to consider these changes in the way physicians and health care organizations are being evaluated and reimbursed, and how the American Thyroid Association can lead the way in this process.

Sincerely,

Antonio C. Bianco, MD, PhD
President, American Thyroid Association