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Quality Measures Workgroup

Quality Measures Workgroup. September 25, 2013. Charge. Overarching Charge to QM WG and ACQM Subgroup:

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Quality Measures Workgroup

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  1. Quality Measures Workgroup September 25, 2013

  2. Charge Overarching Charge to QM WG and ACQM Subgroup: • Develop recommendations for how electronic clinical quality measure concepts and specific measures could be used in place of MU objective measures to “deem” eligible providers (EPs) and eligible hospitals (EHs) as meaningful users through their ability to perform on quality outcomes. Specific Charge to QM WG: • HIT-sensitive outcome measures for EPs are ideal for deeming. • What are the criteria and the potential framework for deeming? • Which measures that currently exist in CMS programs are appropriate to use for deeming? • Eligible professionals and group reporting • What parameters should be used for a group reporting option for MU overall (including deeming). • If there is a group reporting option, how do you attribute a provider's membership in a group and his/her ability to receive incentives (or avoid penalties)? Office of the National Coordinator for Health Information Technology

  3. Previous Discussion on Deeming • Deeming: • HIT-sensitive, outcome-oriented • Population focused (i.e., Million Hearts, disparities, frail elderly) • Framework would support: • High or improved performance • Reduction in disparities • Encompass the aspects of the MU Stage 2 objectives but does not need to map one-to-one • Patient-reported outcome measures Office of the National Coordinator for Health Information Technology

  4. ACQM Subgroup Discussion • Focused on recommending measures that were global indicators of health • e.g., patient-reported outcome of how well the system coordinated care for the frail elderly • Healthcare outcomes or intermediate outcomes would be used to ensure improvement on the global indicator but not required for reporting • e.g., readmissions rates, total cost of care, number of days living in the community • Also wanted to be sure that this framework would address the burden to the system to implement and report this information Office of the National Coordinator for Health Information Technology

  5. Goals for this Call • Discuss draft criteria and examples for “deeming” of eligible providers • Develop final draft recommendations on the criteria and exemplars for HIT Policy Committee meeting on October 2 Office of the National Coordinator for Health Information Technology

  6. * Table 1 from A Framework For Accountable CareMeasures. Posted in Health Affairs blog by Richard Bankowitz, Christine Bechtel, Janet Corrigan, Susan D. DeVore, Elliott Fisher, and Gene Nelson on May 9, 2013.

  7. Draft Criteria • State of readiness: measure is in widespread use or ready for use in Stage 3 • Preference for alignment with other measurement programs (e.g., PCMH, readmissions, CAHPS) • Preference for eCQMs • HIT-sensitive: evidence that the relevant HIT functions (e.g., clinical decision support) linked or associated with the eCQM result in improved outcomes and/or clinical performance Office of the National Coordinator for Health Information Technology

  8. Draft Criteria • Preventable burden: evidence that measurement could support potential improvements in population health and reduce burden of illness • Supports health risk status assessment/outcomes AND improvement:supports assessment of patient health risks that can be used for risk adjusting other measures and assessing change in outcomes AND demonstrates improvement • Enables patient-focused longitudinal care: enables assessment of a longitudinal patient-focused episode of care Office of the National Coordinator for Health Information Technology

  9. Draft Criteria • Cross-cutting in focus: preference for measures that are applicable across settings and conditions • Feasible for implementation: benefit of measuring outweighs the burden of data collection and implementation Office of the National Coordinator for Health Information Technology

  10. Million Hearts Exemplar Office of the National Coordinator for Health Information Technology

  11. Frail Elderly Exemplar

  12. Questions for Discussion • Are the draft criteria correct? What addition or changes should be made? • Recognizing that there are tensions between some of the draft criteria, which, if any, should be prioritized? • Are the exemplars included appropriate and aligned with the criteria? • What additional measure concepts should be recommended for future development to enable “deeming” of EPs? Office of the National Coordinator for Health Information Technology

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