- CMS has put the finishing touches on its yearly list of quality measures under consideration for use in Medicare value-based care purchasing programs, the agency announced this week.
The list, published in conjunction with the National Quality Forum (NQF), is intended to give healthcare stakeholders the opportunity to provide input and suggestions on the use of process and outcome metrics for pay-for-performance financial arrangements, says Kate Goodrich, MD, MHS, Director of the Center for Clinical Standards and Quality.
“Medicare and other payers are rapidly moving toward a health care system that rewards high quality care while spending taxpayer dollars more wisely. Foundational to the success of these efforts is having quality measures that are meaningful to patients and providers alike, and that drive improvement and better outcomes for patients,” she wrote in a CMS blog post.
“Ultimately, these measures may help patients and families choose the nursing home, hospital, or clinician that is best for them, and can help providers deliver the highest quality of care to their patients.”
This year’s list of 97 measures will inform major Medicare initiatives including the Medicare Shared Savings Program, the EHR Incentive Programs for hospitals and critical access hospitals, and the Merit-Based Incentive Payment System (MIPS).
The measures will also be applicable to a number of other patient safety and data reporting programs, including the Hospital-Acquired Condition Reduction Program, Hospital Value-Based Purchasing Program, Long-Term Care Hospital Quality Reporting Program, as well as quality reporting projects geared towards home health, hospice, rehabilitation, and psychiatric facilities.
MIPS has the most measures under consideration, with 35 suggestions, followed by the Hospital Inpatient Quality Reporting Program with 19 and the Prospective Payment System-Exempt Cancer Hospital Quality Reporting Program, which has ten measures awaiting stakeholder input.
Patient-reported outcomes measures (PROMs) make an appearance in the list, especially for issues related to quality and satisfaction with hospice care, surgical care quality, and certain pain management metrics related to MIPS.
While relatively few hospitals currently collect and leverage PROMs data as part of their routine quality improvement strategies, patient-reported information is becoming increasingly important to organizations financially responsible for long-term results and a broader array of patient satisfaction and experience factors.
PROMs data will be especially critical for eligible participants in MIPS, which focuses on creating a collaborative, patient-centered care environment for consumers.
“[PROMs] are measures of organizational structures or processes that foster both the inclusion of persons and family members as active members of the health care team and collaborative partnerships with health care providers and provider organizations or can be measures of patient-reported experiences and outcomes that reflect greater involvement of patients and families in decision making, self-care, activation, and understanding of their health condition and its effective management,” CMS explained in the proposed rule for MACRA implementation earlier in 2016.
While PROMs are gaining momentum, the majority of measures under consideration for 2017 focus on more traditional process and outcome issues, such as screening rates, chronic disease management tasks, adherence to treatment protocols, and data reporting capabilities.
“CMS will continue aligning measures across programs whenever possible, including establishing ‘core’ measure sets, and, when choosing measures for new programs, it will look first to measures that are currently in existing programs,” the document says in response to common criticism that there are too many measures available, and that many are repetitive and produce unnecessary reporting burdens for providers.
“CMS’s goal is to fill critical gaps in measurement that align with and support the National Quality Strategy,” the document adds. “The NQF already endorses many of the measures contained in this list, with a number of other measures pending endorsement.”
CMS and NQF have been collaborating on this list for six years, Goodrich says, through the Measure Applications Partnership (MAP).
“Together we have worked to make the process more efficient and the feedback more meaningful,” she wrote. “The input that we receive from the MAP is invaluable, and reflects the viewpoints of many experts in the field of quality and value, most importantly patients and consumers.”
“We believe it is critically important to hear all voices in the selection of quality and efficiency measures that are used for accountability and transparency purposes and look forward to another successful pre-rulemaking season,” Goodrich said. “We are committed to working with patients, clinicians and others on how to best measure the quality and value of care while reducing burden on providers and driving improved outcomes for patients at lower costs.”
Stakeholders may add their comments until December 2, 2016 through the National Quality Forum’s submission system.