New study analyzes cost, ROI for quality reporting of diabetic care for PCPs

Data collection and quality reporting for diabetic patients cost primary care practices almost $10,000 per year, according to a new report that cautions policymakers to consider the cost of implementation and maintenance when mandating value-based purchasing initiatives.

Diabetes care is more than twice the cost of care for non-diabetic patients, and programs related to meaningful use of health information technology add even more financial pressure to practices, according to the report, published in the Journal of the American Board of Family Medicine. Quality measurement requirements are only expected to increase, yet the study notes that little data exist quantifying what such requirements actually cost a medical practice.

In this report, researchers analyzed costs to implement and maintain quality reporting systems at six primary care practices in Colorado that each were participating in a diabetes quality improvement program. Three of the practices used electronic health records systems, and three still maintain paper records.

The practices studied served an average of 208 diabetic patients, resulting in an estimated $74.77 per patient in implementation costs, or $15,552 per practice. On top of that, annual total maintenance costs were around $9,553 per practice, or $45.93 per patient annually.

Researchers were not able to determine return on investment for those costs, according to the report, because the practices were not able to provide any quantifiable data. But each practice reported a perceived improvement in the quality of care they offered their diabetic patients as a result of their data collection and reporting efforts. Physicians valued the way the data helped them manage patients and, although the practices hinted at financial benefit through bonuses or pay-for-performance programs for the data collection and reporting, no hard evidence backed those assumptions.

Each practice also reported dependency on external resources to run their collection and reporting systems and admitted it would be difficult to continue their quality improvement efforts without outside resources or financial incentives.

“Policymakers must become aware of the financial and cultural impact on primary care practices when considering value-based purchasing initiatives,” the study authors say. “Multiple well-meaning but disparate strategies of payers and regulators have resulted in overlapping reporting and documentation requirements being imposed on busy primary care practices, coupled with meaningful financing mechanisms that recognize the cost of quality improvement, are critical precursors of sustained model of care. If financial incentives are to be linked with outcomes, new systems and resources also would be needed to implement and manage the collateral data collection and reporting that will be required to earn financial incentives."

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