Bruce Sherman to Represent NBCH on NQF Workgroup

NBCH is pleased to announce that Bruce Sherman, MD, FCCP, FACOEM, Medical Director at Canton, OH-based Employers Health, will be representing NBCH on the National Quality Forum Measure Applications Partnership (MAP) Clinician Workgroup.

MAP, a public-private partnership convened by the National Quality Forum, provides input to the Department of Health and Human Services on the selection of performance measures for public reporting and performance-based payment programs. In convening MAP, NQF brings together stakeholder groups in a unique collaboration that balances the interests of consumers, businesses and purchasers, labor, health plans, clinicians and providers, communities and states, and suppliers. Read more about MAP here.

The Clinician Workgroup provides input to the Coordinating Committee on matters related to the selection and coordination of measures for clinicians, particularly in the office setting. See more about the Clinician Workgroup here.

Bruce joins other Organizational Members on the Workgroup, including David Hopkins, Senior Advisor at the Pacific Business Group on Health, and Cheryl DeMars, President and CEO of The Alliance.

Opportunity to Participate on NQF Committees

Building on prior efforts that support consumer and purchaser decision-making in health care based on cost and quality, the National Quality Forum (NQF) is establishing new Standing Committees to review performance measures in high priority areas: cost and resource use measures, and measures of hospital admissions and readmissions. These projects will address issues that are critically important to consumers and purchasers. By injecting your coalition voice into the endorsement process and into oversight of the portfolio of measures in these topic areas, you can help ensure that the measures used for quality improvement and CMS reporting and payment programs are measures that matter to consumers and purchasers. 

Nominations for these Standing Committees are due on November 12, 2013 and additional information on each topical area is provided below and on the NQF website. Please note that if you are selected to serve on a Standing Committee, you will be expected to serve for a two- or three-year term, and participate in conference calls, web and in-person meetings, and offline measure reviews.

• Cost and Resource Use: Building on previous work this effort will continue to evaluate cost and resource use measures. Initially, this work will focus on cardiovascular and pulmonary conditions.

• All-Cause Admissions and Readmissions: This work will build on a number of previous NQF projects addressing readmissions related to specific conditions or settings, as well as a 2012 project examining all-cause readmission measures. This Committee is particularly important because the Medicare Hospital Readmissions Reduction Program, a pay-for-performance program that ties a financial penalty for hospitals to excess readmissions, is required to use NQF-endorsed measures of readmissions.

We hope you will seize this opportunity and join the Consumer-Purchaser Alliance in our efforts to drive health care quality and affordability for consumers and purchasers.

For support from the Consumer-Purchaser Alliance staff in learning more about these projects or submitting a nomination, please get in touch with us by phone or email:

• Stephanie Glier, Senior Policy Analyst, sglier@pbgh.org or 415-615-6341 
• Emma Kopleff, Senior Policy Advisor, ekopleff@nationalpartnership.org or 202-238-4875

NQF Announces Quality Measurement Priority Topics

Under contract with the Department of Health and Human Services (HHS), the National Quality Forum (NQF) will recommend priorities for performance measurement within five topic areas specified by HHS:

• Adult Immunization— identifying critical areas for performance measurement to optimize vaccination rates and outcomes across adult populations 
• Alzheimer’s Disease and Related Dementias—targeting a high-impact condition with complex medical and social implications that impact patients, their family members, and their caregivers 
• Care Coordination—focusing on team-based care and coordination between providers of primary care and community-based services in the context of the “health neighborhood” 
• Health Workforce—emphasizing the role of the workforce in prevention and care coordination, linkages between healthcare and community-based services, and workforce deployment 
• Person-Centered Care and Outcomes—considering measures that are most important to patients—particularly patient-reported outcomes—and how to advance them through health information technology 

Topic-specific committees will review the evidence base and existing measures to identify opportunities for using performance measurement to improve health and healthcare, and to reduce disparities, costs, and measurement burden. Nominations for the five committees that will make the recommendations are now being accepted; NQF encourages members to apply or to nominate colleagues. Members can also attend the committee meetings in-person or virtually, and can comment on draft recommendations.

Webinar on New NQF Resources

National Quality Forum (NQF) will be hosting a webinar next Friday, July 26th from 1:00 – 2:30 pm ET, on the launch of NQF’s Quality Positioning System Version 2.0 and the Field Guide to NQF Resources. The Quality Positioning System (QPS) is a web-based tool that is available to the public to help navigate NQF’s existing measures portfolio. Driven by feedback from users on version 1.0, this next iteration of the QPS includes several new features, such as capability to: 

• search for measures by their inclusion in Federal reporting and payment programs; 
• provide feedback at any time about the use and usefulness of measures; and 
• view measures that are no longer NQF-endorsed. 

In addition to the QPS, the webinar will also provide an overview of the Field Guide to NQF Resources.

If you would like to register, please click here. If you have any questions please contact Diane Stollenwerk at dstollenwerk@qualityforum.org.

NQF Seeks Board of Directors Nominations

NQF is seeking qualified candidates for its Board of Directors. Nominees should:

• Be recognized leaders in the health care field; 
• Have demonstrated expertise and experience in health care quality measurement; and 
• Be willing to serve and commit time, energy, and effort to NQF activities. 

The Board of Directors welcomes candidates from diverse professions and perspectives, including consumers, purchasers, employers, payers, and health care providers, among others.

We encourage those interested to learn more about the Board’s roles and responsibilities on the NQF website. Self-nominations are welcome. Third-party nominations must indicate that the individual has been contacted and is willing to serve.

All materials should be emailed to nominations@qualityforum.org with the subject line “Board Nominations."

Nominations must be received by Thursday, June 20, 2013 at 6:00pm ET.

National Quality Forum Endorses Four New Sets of Measures

On Friday, August 10, the National Quality Forum (NQF) endorsed new measures in four new domains of care: cancer, patient safety, care coordination, and disparities.

The 22 cancer care measures are focused on conditions such as leukemia, prostate cancer, and multiple myeloma, but also on issues that affect care delivery – including radiation dose limits, hospice readmissions, and care planning.

Two new patient safety measures that are focused on complications were endorsed. The measures address venous thromboembolism prophylaxis and current medication documentation in medical records.

The 12 measures of care coordination touch on such critical areas of concern as reconciling patients’ medications, establishing advance care plans, and the timely availability of medical records (to other caregivers and patients themselves) when patients are discharged from hospitals and other in-patient facilities.

The 12 disparities measures are focused on healthcare disparities and culturally competent care for racial and ethnic minority populations.

NBCH is in the process of developing member education and strategy related to measures. If you have feedback on how NBCH can meet your coalition's needs in this area, please contact Colleen Bruce.

Opportunity to Provide Input on NQF’s Measure Registry

Health care stakeholders have expressed interest in being able to consistently identify and track measures and their related versions, including eMeasures, along the measure development, endorsement, and use pipeline. HHS has contracted with the National Quality Forum (NQF) to explore key issues and considerations for a single system or approach to gathering, storing, and accessing measure information.  This project is titled the Measure Registry Needs Assessment. In its role as a neutral convener, NQF will gather perspectives and information from any interested stakeholders across the quality measurement enterprise. The information gathered through this process will be publicly available for review and use by any individual or organization. 

NBCH has been asked to participate in some initial meetings with NQF staff.  We have emphasized that the registry should be created with the end-user in mind – particularly employers and consumers – rather than with the measures developers in mind, which was CMS’s original intent. Our recommendation is that NQF use this as an opportunity to boost use of measures by employers and consumer groups. 

In order to give further voice to that recommendation, all coalitions are invited to participate in a webinar with NQF on Thursday, July 26 at 1:00 (eastern).  This is a great opportunity to ask questions or voice concerns about measure use.  Specifically, coalitions may want to emphasize the following points:

·         The need to link measure information with use and impact.

·         The registry will be most helpful if it has the functionality to generate reports and aggregated results about which measures are currently in use for cost and quality transparency and payment in both the public and private sector

·         Coalitions could also simply express the need to have implementation guidance for measure specifications. 

These and any additional topics or issues for discussion would be welcomed by NQF.  Don’t miss this opportunity to provide a unique and valuable perspective on behalf of your employer members!

Finally, NBCH is exploring ways to support our members in your efforts to use measures in your activities. We request your input on these ideas, and your feedback about whether this would be a valuable resource for you. Please email Colleen with your thoughts, and we will discuss them at the next all member meeting on August 21, 2012. 

Healthcare systems Criticize NQF Over Support of Readmissions Measure

A recent Modern Healthcare article (free registration required) states that a group of eight large hospitals and health systems are taking the National Quality Forum (NQF) to task, decrying not only the organization's endorsement of a measure targeting hospital readmissions, but also calling into question the NQF's entire consensus-reaching process.

In a two-page appeal letter sent to NQF on May 24, the hospitals and health systems raised serious concerns about the potential impacts of a hospital-wide all-cause readmissions measure, which was endorsed by NQF on April 24 and discussed in a June 11 conference call. They state that without adequate risk adjustment and room for exclusions, the readmissions measure could “create confusion, limit hospitals' ability to identify improvement and prompt others to unfairly judge the performance of hospitals.

Providers also worry that the measure, which they see as unreliable, will likely be used by the CMS to gauge hospital performance and determine Medicare payment. The CMS' Readmissions Reductions Program, mandated by the healthcare reform law and set to begin in fiscal year 2013, will reduce Medicare payments for hospitals with the highest rates of readmissions. Many are speculating about how the recently endorsed readmissions measure will fit into that program.

The measure, developed by the CMS and researchers at Yale University, New Haven, Conn., estimates a single risk-adjusted 30-day readmission rate for each hospital, covering all conditions and procedures related to general medicine, neurology, cardiovascular care, cardiorespiratory care, surgery and gynecology.

Providers' unease about linking preventable readmissions and quality is not surprising, said Dr. Ashish Jha, associate professor of health policy and management at the Harvard School of Public Health, Boston. Jha co-authored an April article in the Journal of the American Medical Association in which he called policymakers' focus on 30-day readmissions misguided. He argues that not all readmissions are preventable, particularly when so many determining factors are out of hospitals' control. Jha said hospitals may be investing their limited time, energy and resources on strategies to prevent readmissions, at the expense of other quality-improvement priorities.

NQF's Measures Application Partnership (MAP) Submits Recommendations to HHS

On Friday, June 1, the Measure Applications Partnership (MAP), convened by NQF, submitted the latest in a series of reports to HHS that provide guidance regarding performance measurement in three important areas: care provided to Medicare-Medicaid dual eligible beneficiaries, care provided in cancer hospitals exempt from Medicare’s prospective payment system, and hospice and palliative care. The reports are notable, in that they address some of our country’s sickest and most vulnerable populations, and also address the unique measurement needs and gaps of those whose needs span multiple settings of care.

• Measuring Healthcare Quality for the Dual Eligible Beneficiary Population: Final Report to HHS
• Read the Press Release
• Performance Measurement Coordination Strategy for Hospice and Palliative Care
• Read the Press Release
• Performance Measurement Coordination Strategy for PPS-Exempt Cancer Hospitals
• Read the Press Release

More information about the work of the MAP is available on the NQF website.

NQF endorse measures for identifying healthcare cost drivers and opportunities to address them

A set of measures for identifying health care cost drivers and opportunities to address them are the first of their kind to be endorsed by the National Quality Forum (NQF). As NQF-endorsed standards, the HealthPartners Total Cost of Care and Resource Use measures complement existing quality measures to provide a common reference point supporting the development of accountable care organizations (ACOs) and payment reform models.

Providers, insurers, government agencies, employers, consumers and other organizations can use the measures to manage costs, drive affordability and improve delivery of healthcare. Full measurement methodology is available at healthpartners.com/tcoc , including background, technical guidelines, reference guides, sample applications and guidance for adoption and use by other organizations.

NQF: Measure Applications Partnership (MAP) Draft Reports Released for Public Comment

MAP is a public-private partnership created for the purpose of providing input to the Department of Health and Human Services (HHS) on the selection of performance measures for public reporting and performance-based programs. Two MAP draft reports are now available for public comment:

The Clinician Performance Measurement Coordination Strategy draft report aims to enhance alignment across federal programs focusing on aligning measures and data sources, characterizing an ideal measure set, defining data platform principles, and determining a pathway for improving measure application. The clinician coordination strategy also features a draft version of the MAP measure selection criteria that will be used to assess fitness of a measure set for use in a specific program.

The Coordination Strategy for Healthcare-Acquired Conditions and Readmissions Across Public and Private Payers draft report identifies three focus areas for aligning public and private efforts to reduce healthcare-acquired conditions and readmissions: measures, data, and specific coordination strategies. All comments must be submitted by Monday, September 12, at 6:00 pm ET.

NQF: Patient Safety–Complications Endorsement Maintenance

The Patient Safety–Complications Endorsement Maintenance Call for Measures is now open. This project seeks to identify and endorse measures that specifically address complications-related patient safety issues. In addition, 47 NQF-endorsed® consensus standards will undergo maintenance review. The Call for Measures is open through Wednesday, September 14, at 6:00 pm ET. Submit your measures now.

Apply for the Eisenberg Award!

Eisenberg Awards Nomination Period
The 2011 John M. Eisenberg Patient Safety and Quality Awards nomination period is now open. The Eisenberg Award recognizes major achievements of individuals and organizations in improving patient safety and healthcare quality, consistent with the aims of the National Quality Strategy—better care, healthy people and communities, and affordable care. The nomination period ends Monday, October 3.