Care coordination is increasingly recognized as fundamental to the successful healthcare systems and improved patient outcomes. Poorly coordinated care regularly leads to unnecessary suffering for patients, as well as avoidable readmissions and emergency department visits, increased medical errors, and higher costs. NQF will review performance measures in the care coordination domain, including measures focused on patient experience of care, health information technology, transitions of care, and structural measures. Read more

Description

The Opportunity

Care coordination is a multidimensional concept that includes effective communication among healthcare providers, patients, families, and caregivers; safe care transitions; a longitudinal view of care that considers the past, while monitoring present delivery of care and anticipating future needs; and the facilitation of linkages between communities and the healthcare system to address medical, social, educational, and other support needs that align with patient goals. Establishing effective communication within and across the continuum of care will help to improve the quality and affordability of our healthcare system and is foundational to successful healthcare systems and improved patient outcomes. According to the National Academy of Medicine, the potential opportunity for cost savings is $240 billion, resulting from care coordination initiatives such as patient education and the development of new provider payment models.

People with chronic conditions and multiple co-morbidities—and their families and caregivers—often find it difficult to navigate our already complex healthcare system. As this ever-growing group transitions from one care setting to another, they are more likely to suffer the adverse effects of poorly coordinated care. Incomplete or inaccurate transfer of information, poor communication, and a lack of follow-up care can lead to poor outcomes, such as medication errors. Effective communication within and across the continuum of care will improve the quality and affordability of our healthcare system. 

NQF has undertaken several projects to provide guidance and measurement of care coordination, including a 2006 project that yielded an endorsed definition and framework for care coordination, a 2010 project in which 25 preferred practices and ten performance measures were endorsed, a 2012 project in which twelve performance measures were endorsed, and, most recently, a project completed in 2014 in which five performance measures were endorsed.

Objectives

NQF will establish a multi-stakeholder Standing Committee to evaluate newly submitted measures and measures undergoing maintenance review and make recommendations for measure endorsement. This Committee will identify and endorse new performance measures for accountability and quality improvement that specifically address care coordination, including measures around medical, social, educational, and other support needs. In addition, the Committee will evaluate consensus standards previously endorsed by NQF under the maintenance process.

NQF Process

NQF will consider measures for endorsement as national voluntary consensus standards. Consensus on the recommendations will be developed through NQF’s formal Consensus Development Process (CDP, 2016). A standing committee will guide this project, which involves the active participation of representatives from across the spectrum of healthcare stakeholders.

Funding

This project is supported under a contract from the U.S. Department of Health and Human Services.

For information about the availability of auxiliary aids and services for NQF’s federally funded projects, please visit: http://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html.

Related NQF Work

Contact Information

For further information, contact Kathryn Streeter at 202-783-1300 or carecoordination@qualityforum.org.

Footnotes

1 IOM, Roundtable on Value & Science-Driven health Care: The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Serious Summary, Washington, DC: National Academies Press, 2010.

2 “Reducing and Preventing Adverse Drug Events to Decrease Hospital Costs,” 2001, U.S. Dept. of Health and Human Services, Agency for Healthcare Research and Quality, March, 2001.

Care coordination is increasingly recognized as fundamental to the successful healthcare systems and improved patient outcomes. Poorly coordinated care regularly leads to unnecessary suffering for patients, as well as avoidable readmissions and emergency department visits, increased medical errors, and higher costs. NQF will review performance measures in the care coordination domain, including measures focused on patient experience of care, health information technology, transitions of care, and structural measures. Read more

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