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Quality Measures Workgroup. September 25, 2013. Charge. Overarching Charge to QM WG and ACQM Subgroup: - PowerPoint PPT Presentation
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Quality Measures Workgroup
September 25, 2013
04/22/2023 Office of the National Coordinator for Health Information Technology
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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)?
04/22/2023 Office of the National Coordinator for Health Information Technology
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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
04/22/2023 Office of the National Coordinator for Health Information Technology
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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
04/22/2023 Office of the National Coordinator for Health Information Technology
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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
* Table 1 from A Framework For Accountable Care Measures. Posted in Health Affairs blog by Richard Bankowitz, Christine Bechtel, Janet Corrigan, Susan D. DeVore, Elliott Fisher, and Gene Nelson on May 9, 2013.
04/22/2023 Office of the National Coordinator for Health Information Technology
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Draft Criteria
1. State of readiness: measure is in widespread use or ready for use in Stage 3
2. Preference for alignment with other measurement programs (e.g., PCMH, readmissions, CAHPS)
3. Preference for eCQMs4. 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
04/22/2023 Office of the National Coordinator for Health Information Technology
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Draft Criteria
5. Preventable burden: evidence that measurement could support potential improvements in population health and reduce burden of illness
6. 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
7. Enables patient-focused longitudinal care: enables assessment of a longitudinal patient-focused episode of care
04/22/2023 Office of the National Coordinator for Health Information Technology
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Draft Criteria
8. Cross-cutting in focus: preference for measures that are applicable across settings and conditions
9. Feasible for implementation: benefit of measuring outweighs the burden of data collection and implementation
04/22/2023 Office of the National Coordinator for Health Information Technology
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Million Hearts Exemplar
Measure State of Readiness
Alignment
eCQM HIT-sensitive
Preventable Burden
Health Risk/Outcom
es & Improvement
Enables Longitudinal
Care
Cross-cutting
in Focus
Feasible
Screening High High High High High High Medium Low High
LDL Control
High High High High High High High Low High
BP Control
High High High High High High High Low High
Smoking Status
High High High Medium High High Medium Low High
HbA1c Control
High High High High High High High Low High
AMI Total Cost of Care
High Medium Low Medium Low Medium High Low High
AMI Mortality
High Medium Low Low High High Low Low High
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Frail Elderly Exemplar
Measure State of Readiness
Alignment
eCQM HIT-sensitive
Preventable Burden
Health Risk/Outcom
es & Improvement
Enables Longitudinal
Care
Cross-cutting
in Focus
Feasible
Screening for Future Fall Risk
High High High High High Medium High Low High
Use of High-risk Meds in the Elderly
High High High High High High High Low High
CG-CAHPS
High High Low High Low Medium High High Medium
Closing the referral loop
High High High High Low Medium High Low High
Re-admissions
High High Low High High High High High High
Total Cost of Care
High Medium Low Medium Medium Medium High High High
04/22/2023 Office of the National Coordinator for Health Information Technology
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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?
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