Disagreement over quality measures regarding contraception has led the American College of Obstetricians and Gynecologists to withhold its imprimatur from the Core Quality Measures Collaborative.

“Although ACOG representatives did participate in the process to select measures to be included in the Core Quality Measures Collaborative process, ACOG did not choose to be recognized for participation until further agreement can be made regarding quality measures related to effective contraceptives and immediate postpartum contraception,” Dr. Barbara Levy, ACOG vice president of health policy, said in an interview. “ACOG believes that measures can help create accountability among health systems regarding contraceptive access, providing an opportunity to prevent unintended pregnancies.”

The Core Quality Measures Collaborative is lead by the Centers for Medicare & Medicaid Services and America’s Health Insurance Plans, with input from the National Quality Forum, medical societies, employer groups, and consumer groups, with the goal of building a uniform set of quality measures to be used by both public and private payers in value-based payment structures.

The first seven sets of measures under the collaborative were announced Feb. 16; ob.gyn. measures were included in this limited release.

For ob.gyn., the measures are blocked into two sets. Metrics in the ambulatory care setting look at frequency of ongoing prenatal care, cervical and breast cancer screening, chlamydia screening and follow-up, and appropriate work-up prior to endometrial ablation. Measures in the hospital/acute care setting include incidence of episiotomy, elective delivery, cesarean sections, antenatal steroids, and exclusive breastfeeding.

Four areas identified for future development include physician-level urinary incontinence screening, more on cesarean sections, Tdap/influenza administration in pregnancy, and HIV screening of STI patients.

ACOG said it will continue to push for the inclusion of contraception measures as part of the measures, particularly as access to them continues to be an issue.

“Although the Affordable Care Act requires insurance plans to cover the full range of Food and Drug Administration–approved contraceptive methods, we know that implementation of this provision has not been universal, and some women’s needs are currently unmet,” Dr. Levy said. “Because of this, ACOG continues to advocate for quality measures that will lead to meaningful improvements in access to effective contraception and immediate postpartum contraception. It is our hope that we can advance the commitment of commercial health insurance plans to promoting the most effective contraceptive methods in a way that meets the needs of more American women.”



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