Changing Healthcare by the Numbers
NQF’s 2012 Report to Congress – Changing Healthcare by the Numbers – highlights the growing use of NQF’s endorsed measures and the organization’s critical role bringing public- and private-sector leaders together to build national consensus on healthcare improvement and measurement strategies. This page presents links to selected case studies and key sections of the 54-page report.
NQF in Action - Case Studies
Eight Years of Hospital Reporting Yields Results
In 2002, three hospital industry associations joined the Department of Health and Human Services, The Joint Commission, consumer organizations, and other stakeholders to form the Hospital Quality Initiative, later renamed the Hospital Quality Alliance. The objective: create a unified approach to reporting hospital performance information to the public. The initiative primarily used NQF-endorsed measures, and yielded significant improvement in hospital performance. By 2009, 86% of hospitals scored at the 90th percentile or above on 22 key NQF-endorsed measures (including those related to heart attack, heart failure and surgical care), up from 20% in 2002. Learn more.
Successfully Linking Quality Measurement to Payment Reform: Blue Cross Blue Shield of Massachusetts
In January 2009, Blue Cross Blue Shield of Massachusetts launched the Alternative Quality Contract, a pay-for-performance program linking payment to quality and cost benchmarks. An overall annual budget is set for each provider organization (such as a multi-specialty group) and takes into account the entire spectrum of care—from inpatient and outpatient services to long-term care and prescription drug costs. Performance and quality of care is evaluated based on more than 60 NQF-endorsed measures. Provider groups that stay within their budget and perform well on clinical quality measures receive financial rewards of up to 10% of the total per-member per-month payments. Learn more.
National Priorities Focus North Carolina Hospitals
The North Carolina Center for Hospital Quality and Patient Safety (NCQC), fueled by the knowledge that the State of North Carolina was ranked as only the 35th healthiest state in the country, set out to find a way to improve patient safety in the state. As a focal point of its activities, the group embraced the priorities and goals of the National Priorities Partnership’s 2008 National Priorities and Goals report. NCQC benchmarked North Carolina hospitals performance to the report’s national safety goals, particularly around reducing infections acquired in the hospital. Among notable achievements: a 46% reduction in central-line associated bloodstream infections over an 18-month time period, translating into approximately 18 lives and $4.5 million saved across 40 hospitals. Learn More.
Physician Performance Published in Consumer Reports
In 2010, the Society of Thoracic Surgeons (STS) joined forces with Consumer Reports magazine to publicly report for the first time ratings of adult cardiac surgery centers and group practices. The ratings generated some 20 million web impressions. The ratings are based on STS’s Adult Cardiac Surgery Database, a repository of more than 4.5 million surgical records representing approximately 94% of adult cardiac surgery centers in the U.S. STS used NQF-endorsed measures of coronary bypass surgery survival and complications, among other measures, to compute the ratings Consumer Reports published. Cardiac surgery centers participate in the program voluntarily and in 2011 about 36% did so. Learn More.
Working with NQF Helped Spur Rapid Evolution of Ophthalmology Measures
NQF provides valuable input to measure developers, offering guidance to focus resources on areas where measurement gaps exist, as well as feedback on measures brought forward for endorsement. The American Academy of Ophthalmology (AAO), long a leader in the development of measures, credits their experience with NQF with enhancing the relevance of their measures for patients and payers as well as ophthalmologists. Most notably, AAO now puts more emphasis on measures that evaluate the actual results of care and patients’ functional status (e.g., visual acuity 90 days after cataract surgery), rather than process-of-care measures. Learn More.
Harmonizing Surgical-Site Infection Measures
The Centers for Disease Control (CDC) and American College of Surgeons (ACS) had long collected near identical surgical site infection measures. This was confusing to hospitals, payers and others interested in comparing institutions with respect to patient safety. Following submission of their measures to NQF for endorsement, CDC and ACS worked to harmonize their competing approaches so as to streamline reporting and enhance comparability. The result is a newly harmonized SSI measure, which the Center for Medicare and Medicaid Services has selected for inclusion in the 2012 final rule of the Inpatient Prospective Payment System. Learn More.
How NQF is Evolving
Improving Care for Vulnerable Populations
Vulnerable populations such as the disabled, special needs children, low-income people, racial/ethnic minorities, and people enrolled in both the Medicare and Medicaid programs often require a higher level of medical care. NQF has recently endorsed a number of measures related to vulnerable populations, and the NQF-convened Measure Applications Partnership (MAP) has focused on better defining their needs and what will matter most in improving the care they receive. Learn More.
NQF’s Focus on Patient Safety
Patient safety measures now represent nearly 15% of NQF’s total measure portfolio.In 2011, NQF updated a number of its safety measures and its list of serious reportable events (SREs), a compilation of largely—if not entirely—preventable events designed to help healthcare professionals assess, measure, and report performance in providing safe care. NQF also developed implementation strategies in support of the Department of Health and Human Service’s Partnership for Patients Initiative. Learn More.
Enhancing NQF’s Measure Portfolio
In 2011, NQF completed 11 endorsement projects—reviewing 353 submitted measures and endorsing 170, or 48 percent. The newly endorsed measures include many outcome and patient safety measures, and measures that focus on populations previously under-represented, including pregnant women and children. NQF has also enhanced its endorsement process, including a requirement that testing of measures be done prior to measure review. It also now integrates re-review of existing measures (maintenance review) with newly submitted measures to identify near identical measures for harmonization and to assure best-in-class assessment. Learn More.
Resource Use Measures – Critical to the Healthcare Value Agenda
Deriving more value from soaring healthcare spending requires having better information on both quality and cost, also called resource use. Yet, limited information exists on how the healthcare delivery system deploys its resources. NQF endorsed its first resource-use measures in the past year. Learn More.