Quality Spine Care

Quality reporting is a rapidly growing area.  Each year, new regulations in the US from the Council of Medicare and Medicaid Services make quality reporting a larger factor in determining reimbursement practices. Quality metrics are common parts of European clinical practice.  Value of care is a focus of all payers, with specific interest directed at assessing the quality of care provided by a given healthcare team.  While there are many publications in this space, no text has sought to provide an overview of quality in spine care. 
Quality measurement and quality reporting are ever growing aspects of the healthcare environment. Quality assessment is valuable to all healthcare stakeholders:  patients, physicians, facilities, and payers. Patients are drawn to facilities that provide high value care; public reporting systems and grading systems for hospitals offer one opinion with regard to "high quality care."  Most physicians email inboxes are inundated with offers of recognition for being a "Top Doc" for a nominal fee.  Some payers offer incentives to patients who chose to be treated at "Centers of Excellence" or similar facilities; the definition of "Excellence" may be unclear.  

There is little consensus on how to measure quality, how to incorporate patient and procedure factors and achieve accurate risk adjustment, and how to define value of care.  Regardless of these challenges, regulatory efforts in the US, as well as numerous international efforts, make quality assessment and quality reporting an important part of physician behaviour.   
Physician and facility reimbursement for procedures are often tied to quality metrics. Spine procedures are costly, elective, and are a focus of many payer-based programs.  Hence, spine care is often a focus of quality reporting efforts.  This text summarizes the state of the art with regard to quality measurement, reporting, and value assessment in spine