ACP Urges a Unified Approach and National Focus on Important and Common Clinical Conditions and Identifying Meaningful Performance Measures to Improve Quality of Care of our Patients in the United States
Focusing on core clinical conditions and meaningful performance measurement and quality over quantity will help improve the care of our patients, ease physician burden, and improve health outcomes
PHILADELPHIA, September 16, 2025 – In a new position paper, the American College of Physicians (ACP) identifies core clinical topics of importance to internal medicine physicians, sets a framework for identifying a streamlined set of core performance measures, and calls for the use of high-quality, evidence-based performance measures to be used nationally across all payers and systems. This is significant because many performance measures currently used are not based on high certainty evidence and are burdensome, with low or no value to patient care. The paper, “Identifying Core Clinical Topics and Recommending Core Performance Measures for Internal Medicine Physicians,” is published in Annals of Internal Medicine.
In the paper, ACP details a structured, stepwise evidence-based approach to identifying the clinical conditions commonly addressed in internal medicine and the performance measures most likely to benefit patients. For example, the authors applied their framework to high-quality osteoporosis and depression guidelines to identify meaningful performance measures to improve clinical outcomes.
In 2023, the U.S. spent $4.9 trillion on health care, or $14,750 per person, and 17.6% of the economy. Despite spending more than any other wealthy nation, the U.S. had worse outcomes. To improve results, many call for shifting from fee-for-service to value-based care, which ties payments to quality. Currently, overburdened internal medicine physicians may address 59 performance measures under Medicare’s payment system, with nearly 350 measures endorsed overall. ACP says to make performance measurement more meaningful and manageable, performance measures should focus on high-priority populations and conditions, align with patient needs, and improve physicians’ experience.
The physician experience is an important consideration given the impact of performance measures on administrative work, reputation through public reporting, and reimbursement. According to ACP, the proliferation of performance measures and associated burden have the potential to inadvertently accelerate primary care workforce shortages and reduce time better utilized to address high priority areas with greater certainty of net benefit and focus on patient’s health care preferences.
“Excessive performance measures that are not linked to rigorous high-quality evidence or patient outcomes create added burden to an already overworked and under-resourced physician workforce, leading to physician burnout.” said Jason M. Goldman, MD, MACP, President of ACP. “In this paper ACP hopes to positively influence the currently challenging and complex process to provide national level guidance to improve the quality of care and outcomes of our patients.”
The position paper was authored by members of ACP’s Clinical Guidelines Committee and Performance Measurement Committee, and Division of Clinical Policy. ACP is a leader in evidence-based medicine and is the only physician organization designated as a GRADE (Grading of Recommendations Assessment, Development and Evaluation) Center, an AGREE (Appraisal of Guidelines for Research and Evaluation) Center, and a member of Cochrane US Network.
About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 172 countries worldwide. ACP membership includes 162,000 internal medicine physicians, related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on X, Facebook,Instagram, Threads and LinkedIn, and subscribe to our RSS feed.
Contact: Lori Bookbinder, 215-351-2431, LBookbinder@acponline.org