Regional Learning Webinar October 7, 2015
Today’s Learning Topic: National Quality Measures Featured Speaker Jeffrey Geppert Advanced Analytics and Health Research Battelle Memorial Institute Learning Objectives What are national quality measures? Why are national quality measures necessary? How are national quality measures created? What are we learning from creating national quality measures?
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Jeffrey J Geppert Advanced Analytics and Health Research Battelle Memorial Institute October 7, 2015
Learning Objectives What are national quality measures?
Why are national quality measures necessary? How are national quality measures created? What are we learning from creating national
quality measures?
What are national quality measures? National Quality Measures are health care performance measures used in national programs Medicare, Medicaid, Children’s Health Insurance
Program (CHIP), Health Insurance Exchanges, Centers for Medicare-Medicaid Innovation (CMMI) Intended Uses
Quality Improvement Comparative Reporting Value-based Purchasing Healthcare Transformation
What are national quality measures? Medicare Fee-forService Spending in 2018 Medicare Fee-forService Beneficiaries in 2018
Source: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Factsheets/2015-Fact-sheets-items/2015-01-26-3.html
What are national quality measures?
Source: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/Value-Based-Programs.html
Why are national quality measures necessary? History Florence Nightingale (1854) and Ernest Codman (1917) CMS hospital mortality rate reports (1989)
Institute of Medicine (IOM) To Err is Human: Building a Safer Health System (1999) Crossing the Quality Chasm: A New Health System for the
21st Century (2001)
Infrastructure goals of National Quality Measures
Scientifically Sound Parsimony Harmonization Consensus
How are national quality measures created? Sources of National Quality Measures Congress Patient Protection and Affordable Care Act (ACA 2010) The Improving Medicare Post-Acute Care Transformation Act (IMPACT Act 2014) Medicare Access and CHIP Reauthorization Act (MACRA 2015) Strategies HHS National Quality Strategy (NQS) and CMS Quality Strategy Aims, priorities and levers
Rule-making
Pre-rule making (Measure Applications Partnership – MAP) Rule making (Federal Register: notice of proposed rule-making, public comment, and final rules for each Federal Fiscal Year)
How are national quality measures created? Measure Development Process CMS Measures Management System https://www.cms.gov/Medicare/Quality-Initiatives-PatientAssessment-Instruments/MMS/index.html A Blueprint for the CMS Measures Management System Version 11.1 August 2015 National Quality Forum (NQF) Consensus Development Process (CDP) Projects (e.g. Cardiovascular Measures 2015) Endorsement Criteria: Importance, Scientific Acceptability, Feasibility, Usability Maintenance and annual updates
What are we learning from creating national quality measures? Impact of National Quality Measures 2015 National Impact Assessment of the Centers for
Medicare & Medicaid Services (CMS) Quality Measures Report
RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework Measure Use addresses selected questions related to three REAIM elements: (1) adoption by providers and entities; (2) reach of measures to populations; and (3) implementation of measures
What are we learning from creating national quality measures? 2015 National Impact Assessment (continued) Measure Results: (1) maintenance of measure results,
including trends and disparities in measure performance, and (2) effectiveness of measures, including changes in health outcomes and costs related to measure performance
Focal points for the 2018 Impact Report: A greater number of program measures and analyses Analysis of data at the patient level A qualitative study on the impact of quality measures at the
provider level A more explicit treatment of health disparities to support the foundational principle of the CMS Quality Strategy
What are we learning from creating national quality measures? Methodological Challenges Process measures to outcome measures Patient- and caregiver-centered Communication and care coordination Adult and child high impact conditions Socio-economic status (SES) and/or socio-demographic
status (SDS) Electronic Clinical Quality Measures (eCQM) Intended Use
What measures are best suited for what programs?
Questions?
Thank you! We thank…. Jeffrey Geppert Our public-private funding partners Each of you for participating
We will send you a follow-up email asking for your feedback on the value of today’s webinar. Reminder: Recording of today’s webinar will be available via our website later this afternoon – please share with your colleagues! www.hcgc.org