NQF Releases Recommendations to Address Low Case-volume Performance Measurement Challenges for Rural Providers 

APR 02, 2019

NQF Releases Recommendations to Address Low Case-volume Performance Measurement Challenges for Rural Providers

Washington D.C.
– The National Quality Forum (NQF) today released the rural health report: Addressing Low Case-Volume in Healthcare Performance Measurement of Rural Providers.

Currently, more than 59 million people live in rural areas. Rural residents are more likely to be in poor health and have higher mortality rates for chronic conditions. These disadvantages are exacerbated by poor access to care compared to urban and suburban communities. Moreover, healthcare providers in rural settings face many challenges when reporting quality measurement data and implementing care improvement efforts to address the needs of their populations. Since 2014, NQF has worked to address these challenges as a key means of driving measurable healthcare quality improvements for rural residents.

One of the most significant measurement challenges for many rural providers is the low case-volume issue. Low case-volume—having too few patients for reliable and valid measurement—impacts rural providers’ ability to:

  • Compare their performance to that of other providers (both rural and non-rural);
  • Identify topics for improvement; and
  • Assess changes in the quality of care over time.

The low case-volume problem is particularly relevant for rural residents and providers because rural areas are, by definition, sparsely populated and access to care patients is often limited due to distance or lack of transportation.

“NQF is pleased to continue its work to improve the quality of health and healthcare for individuals in rural areas of the U.S. by explicitly addressing the critical low case-volume measurement challenge.” said Elisa Munthali, senior vice president of quality measurement at NQF. “Our work to date has shown that rural providers are eager to participate in quality improvement and reporting activities, and this work will help make that happen.”

The Measure Applications Partnership (MAP) Rural Health Technical Expert Panel elicited expert input on promising statistical methods that could address the low case-volume challenge, as it pertains to healthcare performance and measurement of rural providers. The expert panel offered key recommendations, including compelling analytical approaches as well as strategic research and policy initiatives that public and private stakeholders can act on to promote use of reliable, valid, and relevant measures in rural areas.

Access the full report.



About the National Quality Forum:
The National Quality Forum (NQF) works with members of the healthcare community to drive measurable health improvements together. NQF is a not-for-profit, membership-based organization that gives all healthcare stakeholders a voice in advancing quality measures and improvement strategies that lead to better outcomes and greater value. Learn more at www.qualityforum.org.