WASHINGTON, DC – The National Quality
Forum (NQF) today released a new commissioned report authored by the RAND
Corporation, “An Evaluation of the Use of Performance Measures.” It evaluates
how performance measures are currently being used in the field, by whom, and
for what purpose; summarizes key barriers and facilitators to using measures;
and identifies opportunities for maximizing standardized performance measure
use moving forward.
The independent evaluation is a first step in better
understanding and analyzing national use of performance measures, as part of
broader efforts to improve health and healthcare. It was performed as part of a
contract with the U.S. Department of Health and Human Services (HHS), who is a
key stakeholder in driving use of standardized performance measures and assessing
if healthcare spending is achieving the best results for patients and
taxpayers.
“This report is an important first step toward helping us
gain a better, more systematic understanding of how NQF-endorsed measures are
being used,” said Janet Corrigan, PhD, MBA, president and CEO of NQF. “We are committed to examining where and how
we can make the greatest impact in improving health and healthcare through
priority setting, the increased use of performance measures, and meeting
measurement gaps.”
Over the course of six months, RAND researchers conducted
interviews with measure end-users—such as community collaboratives,
health plans, state and federal government agencies, and consumer groups—and
performed a review of publicly available documents and materials from websites.
Nearly all instances of measure use—to include public reporting,
payment and network selection, accreditation and certification, and quality
improvement—included
an NQF-endorsed measure, with only 1 percent of organizations studied not using
any NQF-endorsed measures.
Organizations cited a number of internal and external
factors driving their use of performance measures, such as legislative
requirements related to quality-based payments and public reporting contained
in the Patient Protection and Affordable Care Act. Others used the measures in response to local
public health issues, such as obesity, or to help operationalize their
individual missions. The ability of data
to construct measures was the single-most important cited factor as either
facilitating or impeding the use of measures.
Respondents noted that NQF-endorsement or widespread use of
a measure enhanced provider buy-in. A
number of areas where measure gaps exist were pointed out, as well as areas where
new specialty measures would be useful. Interview
participants also stressed the need for better alignment between measures used
in the public and private sectors around national priorities.
“NQF is already invested in advancing a number of opportunities
raised in the RAND study through the work of the NQF-convened National
Priorities Partnership (NPP) and Measure Applications Partnerships (MAP), the
measure endorsement process, and tools to support frontline implementation,”
said Tom Valuck, MD, JD, senior vice president, Strategic Partnerships at NQF.
For example, NPP is establishing priorities and tracking
alignment with the National Quality Strategy, while MAP is assessing the use of
“best available” measure sets for payment and public reporting programs. The
measure endorsement process fills critical gaps and is looking to emphasize
harmonization of measures to reduce provider burden and patient confusion. Finally,
NQF’s new web-based tool, the Quality Positioning System (QPS), helps make NQF measures
more accessible and, along with other community-oriented work such as the
Community Tool to Align Measurement, has corroborated measure gap areas.
The full report, “An
Evaluation of the Use of Performance Measures,” is now available
online.
Learn more about NQF’s measure endorsement process, QPS,
Community
Tool to Align Measurement, and the NQF-convened MAP and NPP.
