• The Gordon and Betty Moore Foundation is supporting the National Quality Forum (NQF) with a $1.08 million grant to advance the quality of care for people with serious illness. NQF will work with the Center to Advance Palliative Care (CAPC) to improve outcomes among community-based providers of serious illness care by aligning performance measurement and accountability.

    Serious illness carries a high risk of mortality and either negatively impacts a person’s quality of life or excessively strains their caregivers. It may include heart failure, cancer, dementia, and many other conditions.

    “Millions of Americans, particularly the elderly, face the challenges of serious illness, and we have an obligation as a nation to ensure that they have access to the high-quality care they need, where they seek it,” said Shantanu Agrawal, MD, MPhil, NQF’s president and CEO. “NQF will work to set standards of quality for serious illness care, and support providers in measuring and improving quality and outcomes at the frontlines of care.”

    With more than 6 million U.S. seniors who are aged 65 years or older and living with multiple health conditions, hospital- and hospice-based palliative care and advanced illness care models have proliferated in recent years. Increasingly, community-based providers are delivering serious illness care through various settings—such as clinics, home-based services, nursing homes, and assisted living facilities—that integrate medical and social services.

    “As the number of Americans who are 65 or older grows dramatically over the next few decades, and as people live longer with serious illness, it is essential to ensure that they have access to high-quality, person-centered, serious illness care outside of hospital and hospice settings,” said Diane Meier, MD, director of CAPC. “We will draw upon NQF’s proven track record of activating stakeholders and its decade of foundational work to improve the quality of care provided to our seriously ill population.”

    CAPC has launched a national initiative, called the Serious Illness Quality Alignment Hub, to work toward aligning U.S. healthcare system accountability mechanisms with standards, measures, and best practices for caring for patients with serious illness in the community. The Hub’s goal is to help standardize quality care for patients with serious illness across the nation. NQF is leading the quality measurement standards efforts of the Hub.

    The population of older Americans is expected to reach 84 million in the next few decades— nearly double its size in 2012. The Moore Foundation is focusing efforts to ensure that the healthcare system is ready and able to care for this population by supporting the development of community-based serious illness care programs.

    “There is a large shift in the healthcare system right now, moving more toward care in the community than in the hospital. To effectively care for the nation’s growing aging population, we need to encourage development of high-quality, community-based serious illness programs,” said Diane Schweitzer, MBA, program director for the foundation’s Patient Care Program. “We also have to be able to effectively measure the quality of these programs, establish accountability systems, and strengthen training and support for healthcare professionals and family caregivers to have the greatest impact.”

    Earlier this year, the Gordon and Betty Moore Foundation convened serious illness care experts and stakeholders, including from NQF, to reach consensus on a definition for the serious illness population, the necessary components of an accountability system, and guiding principles for quality measurement. Participants also identified a starter set of quality measures, future pathways for implementation of an accountability system, and areas where more research is needed to advance serious illness care. NQF’s new initiative with CAPC will build on this work.