NQF Provides Measure Recommendations to HHS for MIPS and Other Federal Healthcare Programs 

Washington, DC—The National Quality Forum’s (NQF) Measure Applications Partnership (MAP) has released guidance on measures under consideration for the new Merit-Based Incentive Payment System (MIPS) and on cross-cutting issues for all federal healthcare programs.

MAP considered 60 performance measures for use in MIPS, a Centers for Medicare & Medicaid Services (CMS) program legislated by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). MIPS combines the Physician Quality Reporting System (PQRS), the Value Modifier (VM or Value-based Payment Modifier), and the Medicare Electronic Health Record (EHR) incentive program into a single program that will adjust eligible providers’ Medicare payments based on performance. The MIPS measures that MAP reviewed were proposed for potential implementation in 2017 in order to collect data for use in the MIPS program in 2019. 

“As the U.S. healthcare system increasingly shifts to a performance-based payment system, MAP’s role as an impartial advisor bringing stakeholders together from across the healthcare spectrum is more important than ever,” said Helen Burstin, NQF’s chief scientific officer. “The recommendations MAP made for MIPS, MSSP, and other federal healthcare programs are advancing measurement to help make better healthcare a reality for all Americans.”

MAP noted the following guidance on cross-cutting issues to HHS:

• Alignment of measures across federal programs is a priority, and it will be important for CMS to pursue alignment of quality measures across the MIPS program and Alternative Payment Models (APMs), as well as alignment with states and the private sector where possible. Fostering alignment across programs was MAP’s rationale for supporting a depression screening measure for MIPS and MSSP that is similar to a measure used in private programs as well as the Adult and Child Core Sets for Medicaid, for example. 
• Measure gaps remain across clinician-level programs, especially in patient-centered areas such as patient-reported outcomes, functional status, and care coordination. According to MAP, patient-focused measures should go beyond patients’ experience with the healthcare system to the impact of healthcare on patients’ health and well-being.
• The impact of patients’ socioeconomic status (SES) and other demographic factors on measure results should continue to be explored, and it is important to take into account whether providers are caring for high-risk populations. MAP noted support for NQF’s two-year trial period examining the impact of SES adjustment on measurement. 

Considering measures for public reporting on Physician Compare, MAP gave input on measures that would be most useful to consumers and patients. MAP noted a preference for measures focused on outcomes (especially patient-reported outcomes), care coordination, population health, and appropriate care, as well as measures that are NQF-endorsed.

MAP also released a report, Cross-Cutting Challenges Facing Measurement: MAP 2016 Guidance, reflecting on its five years of recommendations to the U.S. Department of Health and Human Services (HHS) on which performance measures should be used in federal healthcare reporting programs. This report highlights major changes in the types of measures submitted for consideration for use and notes that this year, for the first time, more outcome measures were submitted for consideration than process measures.

MAP noted that as the U.S. healthcare system increasingly shifts to paying providers based on patient outcomes, it is important to ensure that measure results are attributed to the appropriate physician, hospital, or other entity. An NQF Committee is analyzing the different approaches to assign patients and their quality outcomes to clinicians and organizations and will provide guidance on how these approaches might be improved.

The call for nominations for the 2016-2017 MAP cycle—the sixth consecutive year of MAP—opens March 18 and runs through April 15, 2016.

###

The National Quality Forum leads national collaboration to improve health and healthcare quality through measurement. Learn more at www.qualityforum.org.