• NQF’s Measure Applications Partnership (MAP) is defining new ways to ensure quality measurement is improving healthcare for patients while reducing burden for clinicians and other providers.

    In a new report, MAP recommends significant improvements to measure sets used in federal programs. The U.S. Department of Health and Human Services (HHS) annually seeks out and considers MAP’s analyses and guidance in the federal rulemaking process for quality and efficiency measures used in various payment and public reporting programs.

    Specifically, MAP recommends that HHS consider the future removal of 51 of 240 measures currently used in seven federal healthcare value-based purchasing, public reporting, and other programs. MAP also provides recommendations for improving measure sets used in nine additional federal programs. In order for CMS to act on these recommendations, it will likely need to engage in rulemaking as well as consider other programmatic needs not taken into account by the MAP process.

    “The 55 million Medicare beneficiaries deserve and expect safe and effective care. The MAP process fosters a focus on high-value measures that will improve care quality and outcomes for patients,” said Chip Kahn, MPH, president and CEO of the Federation of American Hospitals, who co-chairs the MAP Coordinating Committee with Harold Pincus, MD, professor and vice chair of psychiatry at Columbia University and director of quality and outcomes research at New York-Presbyterian Hospital.

    “Getting to measures that matter for improving patient care without creating unnecessary administrative burdens is a balancing act,” said Pincus. “To get it right, we need more feedback from patients, frontline doctors and other healthcare professionals on what works and what needs improvement in healthcare quality measurement.”

    Convened in 2011, MAP is a public-private partnership that provides recommendations to HHS on the use of quality and efficiency measures in federal public reporting and value-based payment programs. More than 150 healthcare leaders from 90 organizations who regularly use measures and measurement information participate in MAP discussions. In its 2017 guidance, MAP addresses the importance of removing measures that are no longer driving improvements in patient care or that do not meet the rigorous scientific criteria for NQF endorsement.

    MAP guidance on future removal of measures includes:

    • ESRD Quality Incentive Program: 4 measures suggested for removal; 18 current measures
    • PPS-Exempt Cancer Hospital Quality Reporting Program: 4 measures suggested for removal; 17 current measures
    • Ambulatory Surgery Center Quality Reporting Program: 2 measures suggested for removal; 15 current measures
    • Inpatient Psychiatric Facility Quality Reporting Program: 7 measures suggested for removal; 20 current measures
    • Outpatient Quality Reporting Program: 13 measures suggested for removal; 29 current measures
    • Inpatient Quality Reporting Program: 6 measures suggested for removal; 62 current measures
    • Home Health Quality Reporting Program: 15 measures suggested for removal; 79 current measures

    MAP continues to encourage a person-centered focus to healthcare delivery, including greater use of patient-reported outcome-based performance measures.

    “Consumers, patients and purchasers are looking to NQF and MAP to get to the best measures, even if they are difficult to report,” said Helen Burstin, MD, MPH, NQF’s chief scientific officer. “They’re counting on us to get it right.”

    MAP stresses the need for a systematic process to incorporate qualitative and quantitative feedback from organizations and providers who implement and use measures and voiced support for NQF’s efforts to gather input from the field about measures.

    MAP notes that higher value measures, including outcome measures, are needed in the Merit-Based Incentive Payment System (MIPS) and Medicare Shared Savings Program (MSSP) programs. In its specific recommendations regarding measures for MIPS, MAP stresses the importance of selecting high-quality measures that drive toward safer and more efficient care. Although MAP does not recommend the removal of any measures from MIPS, it emphasizes the need for measures that will drive meaningful improvements in care. MAP recognizes that removal of measures from MIPS must be balanced with the need to ensure all eligible clinicians can participate.

    The new reports follow the February release of MAP’s final measure recommendations for 74 performance measures under consideration for use in federal healthcare programs, as well as specific guidance for programs addressing post-acute care (PAC) and long-term care (LTC) and hospital care.

 
 
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