Measure Applications Partnership Submits Recommendations for Post-Acute Care and Long-Term Care to HHS 

Washington, DC - At the request of the Department of Health and Human Services (HHS), the Measures Application Partnership (MAP), a public-private, multi-stakeholder group of healthcare leaders convened by the National Quality Forum, has submitted its recommendations on the improvement and coordination of care by post-acute care (PAC) and long-term care (LTC) providers.

Patients cared for by such providers, primarily people over age 65, often transition between sites of care—moving among their homes, hospitals, and PAC and LTC providers as their health and functional status changes. These patients are particularly vulnerable and costly to the system, given their clinical complexity and the multiple transitions they endure. A coordinated performance measurement approach across these PAC and LTC providers—along with an enhanced capacity to use health information technology (health IT) resources—is imperative to meet the needs of the patients who depend on these services, a new report from the MAP recommends.

“As a generation of baby-boomers nearly 75-million strong approaches retirement, it is essential that we prepare for the increased needs to come,” said Elizabeth McGlynn, PhD, co-chair of the MAP Coordinating Committee. “Better and smarter quality measurement that places the needs of patients and their families at the forefront will help us identify ways to use health care resources more effectively and efficiently.”

The report, Coordination Strategy for Post-Acute Care (PAC) and Long-Term Care (LTC) Performance Measurement, recommends that HHS:

• define core measure concepts for PAC and LTC performance measurement to harmonize measurement and promote common goals across providers;
• highlight the need for and use of uniform data sources and health IT so that data can be collected once, in the least burdensome way, and for multiple purposes; and
• determine a pathway for improving measure applications through filling priority measure gaps, developing standardized care-planning tools, and monitoring for unintended consequences.

“Achieving the alignment of performance measurement holds promise for facilitating coordinated care and reducing data collection burden across PAC and LTC settings, but will require earnest effort from the public and private sectors,” said Carol Raphael, MPA, chair of the MAP Post -Acute/Long-Term Care Workgroup. “We hope this report will spark a move toward greater harmonization of measures and uniform data sources.”

The report also identifies “high leverage” areas for performance measurement and core measure concepts for PAC and LTC providers, which build on the priorities put forth in the federal government’s National Quality Strategy last year. These core concepts include the routine measurement of the functional, cognitive and mental health status of patients; experience of care; the number of falls, pressure ulcers, and adverse drug events they experience; infection rates; avoidable readmissions; and the existence of care transition plans for every patient.

The report’s conclusions primarily apply to a subset of PAC and LTC providers including: home health care providers, short- and long-term stay nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals.

The report is one of four MAP has now submitted to HHS outlining more coordinated approaches to making healthcare safer and enhancing facility and clinician measurement and performance. An overall MAP report on more than 350 measures under consideration by HHS for nearly 20 clinician, hospital, and PAC and LTC measurement programs was submitted to HHS on February 1. MAP was created for the explicit purpose of providing input to HHS on the selection of performance measures for public reporting and performance-based payment programs. MAP is composed of 60 organizations representing major stakeholder groups, including employers, consumers, labor, health insurance, hospitals, and other healthcare facilities. Some 40 subject-matter experts and 9 federal agencies also took part in the deliberations. MAP’s diverse, public-private nature ensures future federal strategies and rulemaking with respect to measure selection is informed upstream by varied organizations that are invested in the outcomes of the measurement decisions made.

The full report is now available online. Learn more about the work of the Measure Applications Partnership.