• The National Quality Forum’s (NQF) Executive Committee agreed on December 22 to ratify the recommendations of the NQF-board appointed Consensus Standards Approval Committee (CSAC) to endorse selected admissions/readmissions measures currently under review but only if specific conditions are met.

    The conditions require that these endorsed measures:

    • be returned to All-Cause Admissions and Readmissions Standing Committee, who will determine which measures should be included in the NQF 2-year risk adjustment trial period for socioeconomic factors
    • be assessed after one year by the standing committee to determine if the measures cause unintended consequences. Possible changes to the measure will be made based on the evaluation of data collected and reviewed during the assessment year.

    The standing committee began its review of the admissions/readmissions measures for endorsement at about the same time as the in-depth work of NQF’s Expert Panel to examine whether and when to risk adjust measures for socioeconomic and other demographic factors. In August 2014, the NQF Board ratified a robust, 2-year trial to assess the impact of risk adjusting relevant quality measures. This policy change and the trial period, which will begin shortly in 2015, are already affecting NQF discussions and deliberations on measure endorsement.

    As a case in point, the standing committee and subsequent member vote did not come to strong consensus for all of the admissions/readmissions measures under review. The CSAC requested that NQF staff undertake additional consensus-building and NQF held an All-Member Web-Meeting, where more than 130 individuals voiced their concerns and provided feedback for the CSAC’s consideration. When polled, participants ranked adjustment for socio-economic status as the highest priority issue for measures in this project.

    The admission/readmission measures are currently open for appeals through January.