The Measure Applications Partnership is a public-private partnership convened by the National Quality Forum (NQF) to provide input to the Department of Health and Human Services (HHS) on the selection of performance measures.
In March 2015, MAP submitted the following reports to HHS:
- When deliberating on specific measures during this year’s Measure Applications Partnership (MAP) pre-rulemaking process, the MAP identified broad measurement issues, including measurement gaps, implementation challenges, and unintended consequences. The Cross-Cutting Challenges Facing Measurement: MAP 2015 Guidance - Final Report outlines several cross-cutting themes across federal programs MAP examined this year, along with issues that were identified for the cross-cutting Medicare Shared Savings Program.
- The Measure Applications Partnership (MAP) reviewed measures under consideration for several clinician programs. MAP’s pre-rulemaking recommendations for measures in these programs reflect the MAP Measure Selection Criteria, how well the measures address the identified program goals, and NQF’s prior work in identifying families of measures. During its review of the measures, MAP identified several overarching issues for clinician programs such as: (1) including more high-value measures in federal programs; (2) a greater focus on parsimony and alignment of measures in programs to reduce burden; and (3) the need of incentives for more meaningful measurement. The MAP 2015 Considerations for Implementing Measures in Federal Programs: Clinicians - Final Report explores those issues in further detail.
- External from the annual Measure Applications Partnership (MAP) pre-rulemaking cycle process, the federal government sought input from the MAP on additional measures under consideration under an expedited timeline. Considered an “off-cycle review”, MAP convened in early- to mid-February to provide recommendations to the Department of Health and Human Services (HHS) on a selection of performance measures to meet requirements of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. This report, MAP Off-Cycle Deliberations 2015 - Final Report, explores those recommendations in further detail.
In February 2015, MAP submitted the following reports to HHS:
- MAP reviewed measures under consideration for nine hospital and setting-specific programs. MAP’s pre-rulemaking recommendations for measures in these programs reflect the MAP Measure Selection Criteria, how well the measures address the identified program goals, and NQF’s prior work in identifying families of measures. During its review of the measures, MAP identified several overarching issues including: (1) the need for a parsimonious set of high value measures, and (2) the need to increase alignment across programs by focusing on comparable performance across settings and data types. This report, MAP Hospital Programmatic Deliverable - Final Report, explores those issues in further detail.
MAP reviewed measures under consideration for five setting-specific federal programs addressing post-acute care (PAC) and long-term care (LTC). MAP’s pre-rulemaking recommendations for measures in these programs reflect the MAP Measure Selection Criteria, how well the measures address the identified program goals, and NQF’s prior work in identifying families of measures. During its review of the measures, MAP identified several overarching issues including: (1) emphasizing harmonization of measures to promote patient-centered care across PAC/LTC programs, (2) coordinating efforts between patient assessment instruments used in PAC/LTC settings to maintain competencies and quality of data, and (3) aligning performance measurement across PAC/LTC settings as well as with other settings to ensure comparability of performance and to facilitate information exchange. This report, MAP PAC-LTC Programmatic Deliverable - Final Report, explores those issues in further detail.
In January 2015, MAP submitted the following report to HHS:
- For the 2014-2015 pre-rulemaking cycle, MAP received from HHS a list of approximately 200 measures under consideration for use in 20 federal programs (MAP 2015 Final Recommendations to HHS and CMS) , covering clinician, hospital, and post-acute/long-term care settings. During the pre-rulemaking review cycle, the federal government looks to MAP, a public-private partnership, to advise on the selection of measures. Over the course of the review process, MAP promotes alignment across HHS programs and with private sector efforts, incorporates measure use and performance information into MAP decision-making, and provides specific recommendations about the best use of available measures and measure gaps. MAP has now completed its fourth pre-rulemaking cycle, culminating in these recommendations. This is the first of three deliverables, and MAP will later release strategic guidance on measurement in different federal health programs, as well as analysis on issues that cut across federal programs or public and private programs.
On November 14, 2014, MAP Task Forces completed the following report:
- This final report contains MAP’s recommendations to HHS for strengthening and revising measures in the Core Set of Health Care Quality Measures for Children Enrolled in Medicaid and CHIP (Child Core Set). MAP supports all but one of the measures in the current Child Core Set for continued use in the program and six measures for phased addition to the Child Core Set. This expedited review focused on addressing high-priority measure gaps as well as cross-cutting and strategic issues. These strategic issues, as well as any newly-endorsed measures in critical gap areas, will be considered further during the MAP’s next review of the Child Core Set, scheduled to be completed by August 2015.
On August 29, 2014, MAP Task Forces completed the following report:
- This final report contains MAP’s recommendations to HHS for strengthening and revising measures in the Core Set of Healthcare Quality Measures for Adults Enrolled in Medicaid (Adult Core Set). To conduct this review, MAP applied its standard measure selection criteria and considered states’ feedback from the first year of implementation to carefully evaluate and identify opportunities to improve the Adult Core Set. MAP supports the continued use of 22 measures, conditionally supports the continued use of 3 measures, and suggests the removal of 1 measure. MAP also recommends three measures for phased addition. The program measure set will continue to evolve in response to changing federal, state, and stakeholder needs and its maintenance should be considered a long-term strategic process.
On August 29, 2014, MAP submitted the following report to HHS:
- This 2014 Input on Quality Measures for Dual Eligible Beneficiaries final report from the Measure Applications Partnership (MAP) presents multistakeholder recommendations for quality measurement in the Medicare-Medicaid dual eligible beneficiary population. Measuring and improving the quality of care and services offers an opportunity to address the needs of these beneficiaries, their families, and their caregivers who often experience complex health and social circumstances. This report builds on prior work by updating the Family of Measures for Dual Eligible Beneficiaries and identifying persistent measure gaps. MAP also provides recommendations for the continued exploration of performance measurement of health-related quality of life for this and other vulnerable populations. Looking to the future, MAP describes an initial approach to gathering stakeholder experience in applying performance measures in Medicare and Medicaid programs.
On July 1, 2014, MAP Task Forces completed the following report:
- This final report from MAP identifies families of measures—sets of related available measures and measure gaps that span programs, care settings, levels of analysis, and populations-related to three National Quality Strategy priorities: Affordability, Person- and Family-Centered Care, and Population Health. The measures selected for each family were reviewed by task forces and the MAP Coordinating Committee and outlined in this report. Additionally, this report builds on prior analyses of gaps in the nation’s measurement capabilities, and it articulates a clear vision on where measurement needs to be and outlines specific opportunities where progress can be made.
On February 28, 2014, MAP submitted the following report to HHS:
- The 2014 Interim Report from the MAP Dual Eligible Beneficiaries Workgroup is the latest in a series to describe quality measurement in the Medicare-Medicaid dual eligible beneficiary population. One of two major topics of the interim report is the creation and use of a family of measures for dual eligible beneficiaries to achieve alignment in measure use across a range of programs.
In January 2014, MAP submitted the following reports to HHS:
- MAP Pre-Rulemaking Report: 2014 Recommendations on Measures for More than 20 Federal Programs includes a review of more than 234 measures submitted by HHS.
- MAP Input on the Quality Rating System for Qualified Health Plans in the Health Insurance Marketplaces provides recommendations to HHS on the performance measures proposed for use in the initial implementation of the Quality Rating System. The purpose of the Quality Rating System is two-fold, enabling consumer choice and supporting regulatory oversight. MAP’s report focuses on identifying performance measures that will best inform consumer selection of health plans in the marketplaces.
On October 15, 2013, MAP submitted the following report to HHS:
- MAP Expedited Review of the Initial Core Set of Measures for Medicaid-Eligible Adults offers a mix of general and measure-specific recommendations to improve the accuracy, breadth, and feasibility of reporting the Medicaid Adult Core Set. This report also includes information that was provided to MAP as background to inform its review of the Core Set, specifically an overview of the population of adults enrolled in Medicaid and the purpose and history of the Adult Medicaid Quality Reporting Program.
On February 1, 2013, MAP submitted the following report to HHS:
- MAP Pre-Rulemaking Report: 2013 Recommendations on Measures Under Consideration by HHS includes a review of more than 500 measures submitted by HHS. The measures apply to nearly 20 federal programs.
October 1, 2012, MAP submitted two reports to HHS:
- MAP Strategic Plan: 2012 - 2015 outlines a three-year strategic plan for MAP. The plan offers actionable steps to make MAP's work more useful to a variety of stakeholders across public and private sectors, and representative of a true partnership in pursuit of national improvement priorities.
- MAP Families of Measures: Safety, Care Coordination, Cardiovascular Conditions, Diabetes report presents a new way of thinking about and organizing measures for use — called families of measures. The families of measures will serve as a starting place and guide for MAP's recommendations to HHS about the best available measures for specific programs, that are also related across multiple care settings. This report focuses specifically on measures for safety, care coordination, cardiovascular conditions, and diabetes.
June 1, 2012, MAP submitted four reports to HHS:
- Measuring Healthcare Quality for the Dual Eligible Beneficiary Population: Final Report to HHS is MAP's second report to address a strategic approach to performance measurement in that unique and clinically complex group. The report discusses a core set of available measures, potential modifications to existing measures, gap areas for future measure development, as well as potential applications and alignment opportunities.
- The Performance Measurement Coordination Strategy for Hospice and Palliative Care provides a strategy to enhance alignment with a focus on three key areas: 1) high-leverage measure concepts for hospice and palliative care to promote common goals across programs; 2) measures that can be readily incorporated into hospice and palliative care measurement programs; and 3) a pathway for improving measure application.
- The Performance Measurement Coordination Strategy for PPS-Exempt Cancer Hospitals identifies four major focus areas: 1) priorities for measuring performance in PPS-exempt cancer hospitals; 2) a core set of available measures plus measure development, endorsement, and implementation gaps; 3) data and health information technology (health IT) considerations; and 4) implications for measuring performance in cancer care beyond PPS-exempt cancer hospitals.
- MAP's Approach to the Strategic Plan establishes MAP's goal and outlines tactics for achieving its objectives. The strategic plan approach will inform MAP's Strategic Plan which will be completed in October 2012.
MAP previously submitted a series of five reports to HHS:
- The MAP Pre-Rulemaking Report: Input on Measures Under Consideration by HHS for 2012 Rulemaking includes a review of more than 350 measures submitted by HHS in December 2011. The measures apply to nearly 20 federal healthcare programs.
- The MAP Coordination Strategy for Post-Acute Care and Long-Term Care Performance Measurement report makes recommendations on aligning measurement, promoting common goals for PAC and LTC providers, filling priority measure gaps, and standardizing care planning tools.
- Readmissions and Healthcare-Acquired Conditions Performance Measurement Strategy Across Public and Private Payers presents a coordination strategy for aligning performance measurement with specific recommendations on a national core set of safety measures, data elements, and incentive structures – all approaches to reducing healthcare-acquired conditions and hospital readmissions.
- Coordination Strategy for Clinician Performance Measurement provides recommendations for coordinating clinician performance measurement across federal programs, with focus on alignment of measures and data sources, reducing duplication and burden, identifying characteristics of an ideal measure set, and promoting standardized data elements linked to achieving overall national aims for improved health and healthcare.
- Strategic Approach to Performance Measurement for Dual Eligible Beneficiaries is an interim report outlining a strategic approach to performance measurement for the dual eligible beneficiary population. It presents a vision, guiding principles, high-leverage opportunities for improvement, high-need population subgroups, illustrative measures, and considers issues related to data sources and program alignment.
As background to MAP's work, NQF sponsored a report from RAND, Payment Reform: Analysis of Models and Performance Measurement Implications