Ambulatory Care - Additional Outpatient Measures 2010

Call for Intent
June 2024

Ambulatory Care - Additional Outpatient Measures 2010

NQF is initiating a consensus development project seeking endorsement of measures for Ambulatory Care - Additional Outpatient Measures 2010
If, after reviewing this Call for Intent, your organization believes it has one or more measures that address the scope and objectives of this project as described below and would like NQF to evaluate them for possible endorsement, please submit a call for intent to submit candidate standards by 04 January, 2010 to complete this process.
NQF has recently converted to electronic submission of materials. To submit your intent, log in with your NQF username and password and complete the form for each intended measure submission. If you have not created an NQF account, please follow the instructions on the log-in page.
NQF has endorsed a wide variety of ambulatory care measures for assessment of the quality of care provided in outpatient facilities such as hospital outpatient departments (HOPD), emergency departments, urgent care facilities, ambulatory surgery centers, community health centers as well as clinician offices. As more NQF-endorsed measures are implemented, the demand for measures to fill important gaps is growing. The implementation and reporting of quality measures for hospital outpatient services builds on previous efforts in the inpatient area, having the same purpose.

Endorsement of measures is intended to encourage hospitals and clinicians to improve their quality of care and to empower consumers with quality information to make informed decisions about their health care.

Ambulatory medical care is the predominant method of providing health care services in the United States and occurs in a wide range of settings. The largest proportion of ambulatory care services occurs in physician offices. Moreover, approximately 11 percent of all ambulatory medical care visits in the United States occur in the ED.i From 1996 through 2006, the number of ED visits increased from 90.3 million to 119.2 million visits annually, a 32% increase.ii Yet the number of hospital EDs in the United States decreased by about 12.4 percent during the same period. Demand and capacity issues have contributed to increased patient wait-time and decreased physician productivity, and they place patients at risk for poor outcomes.
From the Medicare perspective, 17% of ED visits are covered by this payment source. Since 2008, CMS has adopted outpatient measures specifically addressing ED and ambulatory surgical center quality of care. CMS projects that total payments for services furnished to people with Medicare in HOPDs during CY 2010 under the Outpatient Prospective Payment System (OPPS) will be $32.2 billion, while total projected CY 2010 payments under the ASC payment system will be approximately $3.4 billion. To date, NQF has endorsed measures for these healthcare facilities, but few measures have been endorsed beyond process measures.

i Schappert SM, Rechtsteiner EA. Ambulatory medical care utilization estimates for 2006. National health statistics reports; no 8. Hyattsville, MD: National Center for Health Statistics. 2008. Available from: nhsr008.pdf.
ii Pitts SR, Niska RW, Xu J, Burt CW. National Hospital Ambulatory Medical Care Survey: 2006 emergency department summary. National health statistics reports; no 7. Hyattsville, MD: National Center for Health Statistics. 2008.
The National Quality Forum seeks to identify and endorse additional measures of outpatient care addressing emergency department and/or urgent care and ambulatory surgery for public reporting and quality improvement.
The candidate measures will be considered for NQF endorsement as voluntary consensus standards. Agreement around the recommendations will be developed through NQF’s formal Consensus Development Process (CDP). This project will involve the active participation of representatives from across the spectrum of healthcare stakeholders and will be guided by a Steering Committee with assistance from multiple, condition-specific Technical Advisory Panels (TAPS).

Any organization or individual may submit measures for consideration. To be evaluated, candidate consensus standards must meet the following general criteria:

-Be fully developed for use (e.g., research and testing have been completed);
-Be intended for use in both public reporting and quality improvement;
-Be open source or in the public domain1; and
-Have an identified measure steward2.

Measure stewards must also have a fully executed Measure Steward Agreement with NQF. Information on submitting measures to NQF can be found on the NQF website.
This project is supported under a contract provided by the Centers for Medicare & Medicaid Services.
For more information, contact Elisa Munthali at (202) 783-1300 or via e-mail at