NQF Provides Recommendations to HHS for Value-Based Purchasing Programs in Hospital, Post-Acute, and Long-Term Care Settings 

Washington, DC—The National Quality Forum’s (NQF) Measure Applications Partnership (MAP) has released two reports outlining cross-cutting issues that affect the delivery of healthcare in hospitals and hospital settings (including dialysis facilities and ambulatory surgery centers) as well as post-acute care and long-term care (PAC-LTC) settings.

These reports, submitted to the U.S. Department of Health and Human Services (HHS), highlight important considerations for the federal government when selecting performance measures related to the care provided to 55 million Americans insured by Medicare in these settings.

“As the healthcare system shifts to new delivery and payment models that promote shared accountability and greater responsibility for patient outcomes, performance measurement must keep pace,” said Helen Burstin, MD, MPH, NQF’s chief scientific officer. “The 150 expert MAP volunteers continue to emphasize the need for better measures in federal programs; the increased engagement of providers, families, and patients; and a more coordinated approach to delivering care across the different healthcare settings—from hospitals to post-acute and long-term care facilities.”

The “MAP 2016 Considerations for Implementing Measures for Federal Programs—Hospitals” report:

• Encourages better integration of hospitals with PAC-LTC settings by leveraging measurement to spur enhanced care coordination and data sharing to avoid unnecessary hospital readmissions;
• Emphasizes the need to engage patients and families as partners in care and notes ways in which measurement can facilitate this essential goal;
• Highlights the need for improved interconnectivity and information sharing among patients, providers, and payers to ensure that health data and information plays a central role in decision-making processes.

The “MAP 2016 Considerations for Implementing Measures for Federal Programs—PAC-LTC” report finds:

• Further testing is needed of measures intended to promote alignment across PAC-LTC settings to ensure they reflect specific patient populations while acknowledging differences in healthcare goals;
• Measure concepts for the PAC-LTC settings should reflect the impact of sociodemographic, socioeconomic, and psychosocial issues, as well as encourage patient and family engagement;
• Measurement gaps remain in care coordination, transitions in care, and other areas that matter to patients and caregivers;
• Shared accountability between providers across the care continuum remains a priority.

The Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, which requires PAC providers to report standardized patient assessment data, as well as data on quality, resource use, and other measures, is an important step toward measurement alignment and shared accountability across the healthcare continuum. Over the past several years, MAP has emphasized the importance of aligning measurement across settings using standardized patient assessment data and acknowledges the importance of preventing duplicative efforts, maintaining data integrity, and reducing the burden of maintaining data on different scales.

This is the fifth consecutive year in which MAP has provided guidance to HHS on performance measures under consideration for use in federal healthcare programs. This year, MAP reviewed 44 measures under consideration for eight programs addressing hospitals, dialysis facilities, and ambulatory surgery centers and 32 measures for six programs addressing PAC and LTC settings.

Additional MAP reports on themes for clinician settings and cross-cutting issues will be published on March 15.

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The National Quality Forum leads national collaboration to improve health and healthcare quality through measurement. Learn more at www.qualityforum.org.