Toward development of evidenced-based quality parameters: What gets counted and who gets paid?

Abstract

and motivate changes in physician behavior and systemsbased practice.Pediatricians must adopt an active role as advisors of these ACA metrics, participating in deliberations about which measures are worth universally adopting. Without pediatric input into these decisions, there is a chance to create a system which rewards metrics over actual patient benefit. Data on pay-forperformance incentives for hypertension management in adults, for example, demonstrated improved compliance with guidelines but no impact on blood pressure levels or rates of stroke (24). Specific patient focused studies on best practice and health care metrics with cost-effectiveness data which are replicable in multiple settings are necessary prior to policy changes.

Academic Advocacy and Promotion: How to Climb a Ladder Not Yet Built

“…The PPC is also responsible for providing monthly policy commentaries for Pediatric Research, which represents a peer-reviewed publishing opportunity. 15 The largest advocacy group within pediatric medicine is the AAP, representing 68 000 members. The AAP, in coordination with an appointed Committee on Federal Government Affairs, Subcommittee on Access, and Committee on State Government Affairs directs the academy's national advocacy efforts.…”

Ensuring breastfeeding-supportive legislation

“…Other aspects of the ACA, if modified, may impact national breastfeeding rates. The ACA penalizes hospitals which under-perform in certain quality metrics such as 30-d readmission or central line associated blood stream infections resulting in reductions of preventable conditions as well as cost (19,20). Formula feeding in the setting of a mother who could breastfeed should be considered among these preventable conditions and included in ACA sanctions (18,19).…”