Shantanu is the former deputy administrator for the Centers for Medicare & Medicaid Services (CMS) and director of one of its largest centers, the Center for Program Integrity (CPI). He led efforts to improve value by detecting and preventing waste, abuse, and fraud in Medicare and Medicaid, and was instrumental in CMS efforts to improve the physician experience with Medicare. A board-certified emergency medicine physician, Shantanu has testified many times before Congress, has been published in numerous medical journals, and is a frequent national speaker on healthcare costs and value. He joined NQF on January 30, 2017.
NQF: What do you see as quality measurement’s role in a new health policy environment?
SA: The need for solid, evidence-based quality measures will continue, even though how and what we measure to improve healthcare quality and value may change. Without measurement, it would be impossible to know whether new payment models are working as intended, and whether patients and consumers are seeing smarter spending and better care.
The science of measurement will continue to evolve to get to the high-value measures that provide consumers, providers, and payers with more meaningful information. NQF is at the forefront of this work to clear the way for next-generation measures that the rapidly evolving healthcare system demands. Our recent report and guide on how to best assign accountability for patients are a critical piece of advancing payment tied to performance.
NQF: How will NQF meet the changing demands of the healthcare system?
SA: NQF is in the midst of a transformation. Guided by our Strategic Plan, we are identifying the most important measures to improve U.S. healthcare. Our work to prioritize measures, coupled with our active efforts to reduce the use of less effective measures, will reduce the measure burden on clinicians and other providers and will help us get to fewer, more meaningful measures overall.
At the same time, we’re working to develop measurement solutions for critically important areas, such as diagnostic quality and safety and telehealth, both of which lack metrics to assess care quality. We’re also working, with great early success, to encourage the development of needed measures that reflect the patient’s voice. Our commitment to ensuring that measurement advances patient care while reducing provider burden and our forward thinking and action to solve the tough challenges in healthcare will be our hallmarks for the future.
NQF: How do you plan to navigate the new policy landscape?
As a physician, I believe that NQF, through measurement, has a critical role in improving the health and well-being of patients across the nation. Physicians and other providers, payers, and all the experts we bring together to advance quality are our partners in this important work. In the weeks and months ahead, NQF will be attuned to policy changes as well as to the voices of our diverse members and stakeholders, including hundreds of volunteers on NQF committees, panels, and workgroups. NQF surely will evolve in a new policy environment, but it will remain grounded in quality care and safety for all patients and consumers.