Encore! EP295: The Not Entirely New but Definitely Improved Way to Measure Primary Care, With Rebecca Etz, PhD

The Not Entirely New but Definitely Improved Way to Measure Primary Care, With Rebecca Etz, PhD (Encore! EP295)

In this Encore, Stacey Richter revisits her conversation with Rebecca Etz, PhD, codirector of The Larry A. Green Center, about an 11-measure instrument built to fairly assess primary care performance — accounting for diverse patient populations without turning measurement into a procedural nightmare.

WHAT YOU'LL LEARN

✅ Why measures are a form of communication, and why mismatched measures demoralize PCPs

✅ How financial incentives tied to hitting a target can distort what an EMR actually documents about patient health

✅ Why primary care is fundamentally a relational field, and why that matters for measuring quality

✅ How PCP practices can spend upward of $40,000 a year of uncompensated time reconciling mismatched measurement standards

✅ How the 11 measures performed differently during COVID, and what that revealed

WHY THIS MATTERS

Fair, well-validated primary care measures aren't a nice-to-have — they determine whether incentive programs reward the work PCPs actually do or push them toward gaming a target instead. Dr. Etz's 11-measure instrument, aligned across patients, clinicians, and payers, is a rare example of a measurement tool built from what primary care actually values rather than what's easiest to count.

MENTIONED IN THIS EPISODE

EP270 with Dave Chase: Apple Podcasts | Spotify (pod.link, unconfirmed — Spotify outage) | Other Apps

EP272 with Guy Culpepper, MD: Apple Podcasts | Spotify (pod.link, unconfirmed — Spotify outage) | Other Apps

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

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00:00 Introduction

04:58 Why is primary care one of the "best-kept secrets" of better health outcomes?

09:45 "Measures are a form of communication."

09:58 "If the way that you are assessed does not actually match up with the work you do…it's pretty demoralizing."

12:48 "It is the outcome of healthcare, but it is not the same thing as quality."

17:18 "It creates a financial incentive to hit a target by any means necessary."

18:53 "We incentivize people to have good outcomes…electronic medical records are no longer simply databases that tell us what the health of the population is."

21:54 "Primary care is a relational field."

23:02 "How does this relate to cost and utilization?"

27:45 How has the measure of PCPs in the time of COVID held up?

28:03 What measure performs worse in the time of COVID?

29:59 EP270 with Dave Chase and EP272 with Guy Culpepper, MD.