Overview

The National Quality Forum (NQF) Measures Applications Partnership (MAP) convened a MAP Rural Health Advisory Group on behalf of the Center for Medicare & Medicaid Services (CMS) to provide input on the measures under consideration (MUC) with the goal to improve the health and healthcare of those who live in rural areas of the U.S.

The Opportunity

More than 59 million Americans—approximately 19 percent of the U.S. population—live in rural areas. Data indicate that individuals who live in rural parts of the country may be more disadvantaged overall than those in urban or suburban areas, particularly with respect to sociodemographic factors, health status and behaviors, and access to the healthcare delivery system.

Healthcare providers serving in rural areas face many challenges in reporting quality measurement data and implementing care improvement efforts to address the needs of their populations. Some rural providers may have relatively few patients or relatively few patients who have certain conditions or receive certain types of services. This low case-volume challenge can affect the reliability, validity, and utility of performance metrics that might otherwise be available to rural providers for measuring care quality. Moreover, due to factors such as geographic isolation or small practice size, rural providers may have limited time, staff, and infrastructure for internal quality improvement efforts and effective participation in quality reporting and value-based purchasing programs.

About the Project

In this project, the MAP Rural Health Advisory Group, with oversight from the MAP Coordinating Committee, will continue to provide recommendations on issues related to healthcare performance measurement challenges for the rural population. Key activities under this project will include:

• Participation by the MAP Rural Health Advisory Group in the CMS pre-rulemaking process by providing feedback on setting-specific measures included on the Measures Under Consideration (MUC) list;
• Presentation of the Rural Health Advisory Group’s most recent recommendations to the MAP Hospital, Clinician, and PAC/LTC Workgroups.

The MAP Rural Health Advisory Group also previously participated into a series of projects related to rural health measurement issues, including identification of high-priority rural-relevant measures susceptible to low case-volume and updating a list of key rural measures.

Objectives

The MAP Rural Health Advisory Group will provide input to the pre-rulemaking process. The Rural Health Advisory Group helps to accomplish the following tasks:

• Provide input to the MAP Workgroups on the rural health perspective on the MUCs during MAP’s annual pre-rulemaking process
• Identify rural-relevant gaps in measurement
• Provide recommendations regarding priority rural health issues, including the challenge of low case-volume and access

Funding

This project is funded by the Centers for Medicare & Medicaid Services (CMS).

Contact Information

For more information, contact the project team via email at maprural@qualityforum.org.