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Transcript of October 7th Regional Learning Session Slides
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?
We welcome your reflections and questions via Webinar chat feature or Text to 614-906-2440
We are recording the webinar - will be available via our website later today
Next In-Person Learning Session: December 4th In-Person 8:30 - 11:30 AM EST Topic: Featuring Regional Healthcare Transformational Activities Nationwide & Ohio Farm Bureau 4H Center, 2201 Fred Taylor Drive
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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
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!