Does USWR Quality Reporting Make it Easier to Do the Right Thing?

Objective: We have previously shown a large gap in practice for diabetic foot ulcer (DFU) off-loading and venous leg ulcer (VLU) compression. We wished to determine the impact of quality reporting on the gap in practice for 3 evidence based interventions critical to wound care.

Methods: We analyzed data submitted to the U.S. Wound Registry (USWR), a Qualified Clinical Data Registry (QCDR) for participation in the Merit Based Incentive Payment System (MIPS). The performance rate of Advanced Practitioners (APs) (e.g. MDs, DPMs, NPs) who submitted wound care quality measure (QM) data for credit under MIPS were compared APs not submitting data on those specific measures.

Findings: In 2016, data on 535 APs were available, representing 21,000 chronic ulcers. Among APs submitting data to CMS on the non-invasive arterial screening of patients with leg ulcers, the performance rate of reporters was 69% vs. 25.7% for non-reporters; for off-loading of diabetic foot ulcers (DFUs) at each visit, 88.5% vs. 28.6%; and for adequate compression of venous leg ulcers (VLUs) at each visit, 80.4% vs. 51.6%.

Conclusion: The gap in practice for DFU off-loading and VLU compression has improved since 2010. QM reporting under MIPS increased the documentation of quality care by 28%- 59.9%. Whether patient outcome is changed is not known and would require analysis for which no funding is available. Quality measure data is now public and will be used by payers to set contracted reimbursement rates and by patients to find providers. USWR QMs are available as SMART apps.