Metrics & Scoring Committee January 18, 2019
Today’s Agenda Welcome & general updates Debrief from HPQMC Update on CQMR Planning for 2020 measure set Review measure retirement checklist Review draft stakeholder survey Identify measure owners Plan for next few months Please note this meeting is being recorded. The recording will be made available on the Committee’s webpage: http://www.oregon.gov/OHA/HPA/ANALYTICS/Pages/Metrics‐Scoring‐Committee.aspx 2
Review December Minutes 3
Health Plan Quality Metrics Committee Update January meeting overview Presentation: Metrics and scoring committee recommendations (MORE LATER!) Discussion: Measure governance Planning for 2020 measure finalization Next meeting: Feb 14, 2019 Update: Health Equity Measurement Workgroup For committee information: http://www.oregon.gov/oha/analytics/Pages/Quality‐Metrics‐ Committee.aspx 4
HPQMC Update ‐ Measure Governance: Final Guidance Measure adoption includes the specifications for the measure as they exist when the measure set is released. If the steward makes changes between this time and the start of the measurement year, those changes will be reviewed and reconsidered using the following process. • If stakeholders or staff note a change in measure intent or measure definition , the measure will be presented for review and discussion at HPQMC to determine the best next step. Feedback from potential users of this measure will be considered in any final decisions. • If stakeholders or staff note a change in process or technical specifications , and no change in measure intent or measurement definition, the measure will stay on the list with the updated specifications made by the measure steward. Operational impacts and changes will be to the discretion of the user that selected the measure. • Measures that use national HEDIS measures or eCQMs must use the most current HEDIS specs that apply to the measurement year without adaptation. These are critical to aligned state and federal reporting. 5
Developmental Measures Updates 6
Obesity Measure Workgroup Update Goal: Glide path to introduce Component 1/ Multisector Interventions in 2021 (year 1) and add BMI measurement change to the measure in 2023 (year 3) January updates Workgroup A (Community investments in multisector interventions) • Key criteria and draft technical specifications have been finalized • NEXT STEPS: Gather feedback from Metrics and Scoring committee and request CCO organizations who want to pilot test the specifications (February or March) • Next meeting: Jan 18 Workgroup B (BMI reporting) • Next meeting: Jan 23 ‐ Kickoff and workplan development for the next two years 7
Health Equity Measurement Workgroup Update December 18, 2018 meeting highlights: • Workgroup agreed to work toward a short‐term solution for February, then focus on a longer‐ term solution • Presentation and discussion on potential measure on primary care access by race/ethnicity • Initial measure criteria: (1) focus on race/ethnicity disparity, and (2) be universally usable by all CCOs Two meetings in January – 1‐hour check‐in on January 14, full meeting on January 25 • Will look at data for the proposed measure on primary care access and consider its feasibility • Will also look at existing non‐incentive CCO measures for potential feasibility • Scheduled to present to HPQMC in February For more information: https://www.oregon.gov/oha/HPA/ANALYTICS/Pages/Health‐Equity‐Measurement‐ Workgroup.aspx 8
Health Plan Quality Metrics Committee Background • SB 440 of 2015 established Health Plan Quality Metrics Committee (HPQMC) • Requires HPQMC to develop a menu of health outcome and quality measures for CCOs and plans offered by PEBB, OEBB, and the Insurance Exchange • Any metrics used for these plans must be on the menu developed by the Committee • Metrics & Scoring Committee became a subcommittee of the HPQMC 9
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Debrief: Metrics & Scoring Proposal to HPQMC (1/3) • Social Determinants of Health – Unanimously endorsed shift to broader SDOH (versus just food security) – Discussion included: o Importance of flexibility about screening tools, but with clear definition of what counts for metric credit (example of good practice is rollout of developmental screening measure) o Being thoughtful about number of domains included o Whether the measure should be at a clinic or plan level (or both) o Importance of environmental scan to learn from other states’ measurement efforts – OHA will convene a workgroup to begin developmental work 11
Debrief: Metrics & Scoring Proposal to HPQMC (2/3) • Health Aspects of Kindergarten Readiness – Unanimously endorsed development of social emotional health attestation measure (plan level measure on social emotional health), and asked that a measure (or measures) be developed that could be used by (a) CCOs and eventually (b) commercial plans – Unanimously endorsed entire measurement strategy (multiple components which build over time) o Preventive dental visits + well‐child visits o Social‐emotional health attestation measure o Follow‐up to developmental screening – Discussion included: o The importance of this work beyond Medicaid, and need to take commercial plans into account in development of social emotional health measure o That attestation measure could help address payment and policy issues; could discuss with Primary Care Payment Reform Collaborative, OHLC, etc. 12
Debrief: Metrics & Scoring Proposal to HPQMC (3/3) • Additional areas of interest: – Suicide – Flu immunizations – Substance use disorders 13
Public testimony 14
Clinical Quality Metrics Registry (CQMR) Update Kate Lonborg, CQMR Program Manager, OHA 15
Refresher: What is the CQMR? • New streamlined quality reporting solution • Consolidates eCQM reporting across programs: – Medicaid EHR Incentive Program – Comprehensive Primary Care Plus (CPC+) (supported) – Merit-based Incentive Payment System (MIPS) (supported) – CCO incentive measures – TBD – additional programs over time • Collects electronic Clinical Quality Measures (eCQMs) specified for CMS programs per national standards – Also will collect state-specific EHR-based CCO incentive measures (smoking prevalence, SBIRT) as aggregated data 16
Clinical Quality Metrics Registry (CQMR) Key Dates • January 14, 2019: Go live for Medicaid EHR Incentive Program to report 2018 eCQMs • February 1, 2019: Go live for Merit-based Incentive Payment System (MIPS) and Comprehensive Primary Care Plus (CPC+) support – If you participate in multiple programs, you may choose to use CQMR to send eCQMs to CMS for MIPS or CPC+ reporting • TBD: Going live later for CCO incentive measures – plan to use for pilots ahead of 2019 reporting 17
2019 Measure Set Alignment - eCQMs 18
Why the focus on eCQMs? • Used in CMS programs, creating some immediate alignment • Incorporated into federal certification criteria for EHRs • Fully specified for reporting electronically (human-readable and machine- readable) • Reportable in standardized format at aggregated and patient levels 19
Scope of CQMR • CQMR will start with Medicaid programs already collecting clinical quality measure data – Improving processes and usability of the data – Offering technical assistance to help with patient-level data reporting – Not trying to displace existing tools • Assessing options to support providers in other reporting • Building the alignment to support “report once” will take time 20
Data collection efficiency opportunities OHA programs Providers* CMS (CPC+, MIPS) * Options to send CQMR via intermediary, such as HIE or registry; API / CCOs interface in EHR; Direct; web portal Other payers 21
Roadmap Today and desired future state Move toward Aggregation Mostly patient-level level aggregated (QRDA I) Move toward Frequency Annual quarterly and of reporting then monthly Expand to Participation Medicaid support more programs Related areas of work: • Metrics alignment – measures and reporting parameters • Pilots to combine clinical and claims data 22
Benefits for Providers and Clinics Providers and clinics get… • Single, streamlined tool with multiple submission options • EHR alignment to reduce need for custom reports and manual data entry • Glide path to robust data : – As providers are ready to send patient-level data, system is ready to support drill-down views – Shows how clinics perform against benchmarks – Offers customizable dashboard views 23
Benefits to CCOs and Payers Coordinated Care Organizations get… • Single, streamlined tool to take in CCO-approved data proposals and submissions • EHR alignment for fewer reporting errors and custom reports • Glide path to robust data : – Supports more patient-level reporting, as providers are ready – Planned functionality to filter accurately by payer – Supports population health management 24
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