NQF-Convened Group Provides Recommendations to HHS for Clinician Value-Based Purchasing Programs and Guidance on Challenges Facing Measurement
Washington, DC – The National Quality Forum’s (NQF) Measure Applications Partnership (MAP) submitted recommendations to the Department of Health and Human Services (HHS) regarding issues to consider when selecting performance measures for clinicians. MAP also provided HHS with guidance on measurement challenges that are endemic across healthcare settings.
The new MAP reports follow recommendations shared with HHS earlier this year related to approximately 200 performance measures under consideration for use in 20 federal healthcare programs, as well as recommendations regarding issues to consider when selecting performance measures for both hospitals and post-acute care/long-term care (PAC/LTC) settings.
“These reports provide policymakers, providers and other stakeholders with important insights into how measures are working in current value-based payment and purchasing programs, as well as how measures could evolve to improve care for millions of Americans,” said Christine K. Cassel, MD, NQF president and CEO.
MAP’s Considerations for implementing Measures in Federal Programs – Clinicians report explores in greater detail issues raised in its earlier report that made pre-rulemaking recommendations to HHS for measures under consideration for the Physician Quality Reporting System and Medicare and Medicaid EHR Incentive Programs (Meaningful Use).
MAP found that while more high-value measures (such as outcome measures, patient-reported outcomes, composite measures, and cost and resource use measures) were included in the current measures under consideration, there were important gaps in measures for multiple chronic conditions, measures for palliative/end-of-life care, and electronic health record (EHR) measures that promote interoperability and health information exchange, among other areas.
MAP also noted that greater focus on composite measures, appropriate use measures, and outcome measures could promote greater parsimony and reduce measurement burden for healthcare professionals. Finally, MAP suggested that the Centers for Medicare & Medicaid Services (CMS) consider “innovative” incentives to encourage more meaningful measurement, for example, waiving non-participation penalties in quality programs in exchange for acting as a test site or participating in a registry.
MAP’s Cross-Cutting Challenges Facing Measurement report is a synthesis of broader issues MAP identified when deliberating on specific measures during the pre-rulemaking process. The report noted that improvements are needed to move toward “measures that matter” in health programs, such as measures of health outcomes, composite measures, care coordination, cost and resource use, and patient safety. MAP identified a number of critical measurement gap areas—for example, in person- and family-centered care—that continue to inform its recommendations to CMS on measure use.
In addition, MAP noted that the Medicare Shared Savings Program would benefit from measures that encourage coordination, such as measures relevant to individuals with multiple chronic conditions, measures in all settings in which patients receive care (ambulatory, acute, and post-acute settings), and measures that span across settings of care.
### The National Quality Forum leads national collaboration to improve health and healthcare quality through measurement. Learn more at www.qualityforum.org.
