Regional Learning WebinarOctober 7, 2015

www.hcgc.org

Today’s Learning Topic: National Quality Measures

Featured Speaker Jeffrey Geppert

Advanced Analytics and Health ResearchBattelle 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?

Source: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-01-26-3.html

Medicare Fee-for-Service Spending in 2018

Medicare Fee-for-Service Beneficiaries in 2018

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-Patient-

Assessment-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 RE-AIM 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!

www.hcgc.org

We thank….

Jeffrey Geppert

Our public-private funding partners

Each of you for participating

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Reminder: Recording of today’s webinar will be available via our website later this afternoon – please share with your colleagues!