Core Quality Measures Collaborative
Why Core Quality Measures? • Wide variability in use of measures across private payers and between public and private programs * • Creates fragmentation in provider quality improvement efforts • Too much focus on processes of care • Lack of quality measures for specialists • Improve “signal to noise” ratio 2
Three Aims of Core Measures Collaborative • Recognize high-value, high impact, evidence-based measures Aim 1 that promote better patient health outcomes, and provide useful information for improvement, decision-making, and payment • Reduce the burden of measurement and volume of measures by Aim 2 eliminating low-value metrics, redundancies, and inconsistencies in measure specifications and quality measure reporting requirements across payers. • Refine, align, and harmonize measures across payers to achieve Aim 3 congruence in the measures being used for payment and other accountability programs 3
Principles of Core Measure Sets NQF-endorsed measures Measure sets should Data collection and Overuse and underuse are preferred or measures achieve three part aim of reporting burden must be measures should both be tested for validity and National Quality Strategy minimized included reliability Measures that focus on Measures should be Measure that cross cut patient outcomes, meaningful and usable Measure Sets should be across conditions (e.g. currently in use and drive by consumers and parsimonious in nature patient experience, safety, quality improvement are applicable to different etc.) are preferred preferred populations Included measures Measures should focus should allow for prudent on clinical quality, physicians to attain patient experience, and success cost 4
Stakeholder Groups Involved in Core Quality Measures Collaborative Provider Groups Health States Plans Core Measures Sets Consumers NQF and Employers CMS 5
Provider Partners 6
Areas of Focus For Core Measures Workgroups ACO / PMCH Medical Oncology Gastrointestinal Orthopedics HIV / Hepatitis C Cardiology Pediatrics OB / GYN 7
Path Forward • Phased-in approach to implementation • Ability to learn from field and identify which measures help improve quality • Iterative process that leads to evolution of core measure sets 8
Open Issues for Discussion 1 Benchmarking 2 Provider Attribution 3 Use of Registry Data 4 Ongoing Updates to Measure Sets 5 Measure Development 9
Need more Information? Additional information can be found by clicking: http://www.ahip.org/News/Press-Room/2016/AHIP,-CMS-Collaborative- Announces-Core-Sets-of-Quality-Measures.aspx https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press- releases/2016-Press-releases-items/2016-02-16.html 10
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