Access the Endorsement Summary (PDF) | Access the Full Report
The Opportunity
Approximately 18 percent of hospital admissions by Medicare beneficiaries result in a readmission in 30 days.1 Reducing these hospital readmissions will aid in improving quality of care for patients and inevitably reduce cost of care.
To achieve quality healthcare across the full continuum, there is a need for more measures that specifically address outcomes of care provided in our nation’s healthcare system. Many outcome measures are inherently relevant because they reflect the reason consumers seek healthcare (e.g., to improve function, decrease pain), as well as reflect the treatment objective of healthcare providers.
To date, NQF has endorsed more than 100 outcome measures, most recently through the multi-phase Patient Outcomes project. However, many gaps remain, including those related to complications, all-cause readmissions, and mortality.
Table of Endorsed Measures (PDF)
About the Project
This project began in October 2011. This consensus standards endorsement project will be an expedited review.
Objectives
This project seeks to identify and endorse additional cross-cutting (not condition-specific) measures for accountability and quality improvement that specifically address all-cause readmissions to hospitals.
As part of this endorsement maintenance project, NQF will solicit all-cause hospital readmissions measures that are not condition-specific. Additionally, as part of this process, all-cause hospital readmissions-related consensus standards that were endorsed by NQF before June 2009 will be evaluated under the maintenance process. Endorsement maintenance provides the opportunity to harmonize specifications and to ensure that an endorsed measure represents the best in class. Evaluating all NQF-endorsed® all-cause hospital readmissions measures and considering new measures will ensure the currency of NQF's portfolio of voluntary consensus standards.
NQF Process
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 consensus standards endorsement project will be an expedited review. The project will involve the active participation of representatives from across the spectrum of healthcare stakeholders and will be guided by a multi-stakeholder Steering Committee.
This consensus standards endorsement project will be an expedited review. In order to meet the legislative deadline required for implementation of all-cause readmissions measures, NQF will conduct an expedited review. The updated policy on the expedited review process was approved by the NQF Board of Directors in the fall of 2010 in order to meet emerging national needs.
Three criteria must be met prior to consideration by the Consensus Standards Advisory Committee (CSAC) for an expedited review:
- The extent to which the measures under consideration have been sufficiently tested and/or in widespread use;
- The scope of the project/measure set is relatively narrow; and
- There is a time-sensitive legislative/regulatory mandate for measures.
Funding
This project is supported under a contract provided by the Department of Health and Human Services.
Related NQF Work
Phase I of the National Voluntary Consensus Standards for Hospital Care: Outcomes and Efficiency project focused on endorsing hospital readmission measures.
Contact Information
For further information, contact Taroon Amin, MA, MPH or Alexis Forman, MPH, at 202-783-1300 or via email at readmissions@qualityforum.org.
1 Medicare Payment Advisory Committee (MEDPAC). Report to the Congress: Reforming the Delivery System. Washington, DC: MedPAC; 2008. Available at http://medpac.gov/documents/Jun08_EntireReport.pdf. Last accessed October 2011.
This project seeks to identify and endorse additional cross-cutting (not condition-specific) measures for accountability and quality improvement that specifically address all-cause readmissions to hospitals. Additionally, as part of this process, all-cause hospital readmissions-related consensus standards that were endorsed by NQF before June 2009 will be evaluated under the maintenance process.
The Call for Nominations closed on October 24, 2011. A steering committee of experts was formed to guide the endorsement process and assess candidate standards.
For information on the Steering Committee formation process, please refer to the Call for Nominations. (PDF)
The Call for Candidate Standards closed on October 31, 2011.
This project includes maintenance review of one consensus standard. As a part of the maintenance review process, NQF sought comments on the implementation and use of these measures, particularly all stakeholders’ experiences with the measures.
See detailed information in the Call for Implementation Comments. (PDF)
The Steering Committee started meeting in December 2011 to evaluate submissions and prepare the draft report.
Measures to be reviewed:
- 0329: Risk-adjusted 30-day all-cause readmission rate
- 1768: Plan all-cause readmissions (REVISED)
- 1789: Hospital-wide all-cause unplanned readmission measure (HWR) (REVISED)
The Steering Committee met in person on December 5-6, 2011 at the National Quality Forum, 1030 15th Street, NW, 9th Floor, Washington DC 20005.
The Readmissions Steering Committee met on Friday, December 16, 2011 via conference call.
The NQF Board of Directors ratified the endorsement of the two readmissions measures.
There was one letter of appeal filed during this time.
Submitted Appeal (PDF)
CSAC will be discussing the letter of appeal that was submitted for measure 1789 on Monday, June 11 from 3-5pm ET.
Review the CSAC Meetings.
