Core MeasuresIntro to U.S. Health Systems

Linda Courtien

Core MeasuresPurpose:

• to compare the quality of care among hospitals using evidence-based, standardized clinical performance indicators

• Ensure a minimum standard of care for all patients who come in with a core measures diagnosis

Goal

• to minimize data collection efforts for these common measures and focus efforts on the use of data to improve the health care delivery process

Core MeasuresHistory:

• 1999: Joint Commission (JC) requested input from various stakeholders to determine core measurement areas

• May 2001: Four initial core measurement areas developed (i.e. acute myocardial infarction, heart failure, pneumonia, pregnancy and related conditions)

• July 2002: JC collaborated with CMS and hospitals became required to report core measures

Core Measure SetsHeart FailurePneumonia

Acute Myocardial InfarctionImmunization

Children’s Asthma CareSurgical Care Improvement Project

Perinatal CareSubstance Use

Tobacco TreatmentHospital-Based Inpatient Psychiatric Services

Venous ThromboembolismStroke

Emergency DepartmentHospital Outpatient Department

Stroke Core Measures

Pneumonia Core Measures

Quality Measures

• Interventions and outcomes that we want the patient to experience

• Publicly reported

• Healthcare organizations are measured based on their ability to meet all of the quality measures for each core measure diagnosis

Meaningful Use• The use of a certified EHR in a meaningful

manner.

• The electronic exchange of health information to improve quality of health care.

• The use of certified EHR technology to submit clinical quality and other measure.

• After 2015, Medicare will require that all hospitals meet meaningful use or they may be subject to a financial penalty.

• Requires the use of a Electronic Health Record system to report required measures to receive incentive payments.

References“Medicare and Medicaid EHR Incentive Program Basics." 24 Nov. 2014. Web. 12 Dec.

2014. <

http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/ Basics.html>

"The Joint Commission." <i>Core Measure Sets</i>. 1 Jan. 2014. Web. 12 Dec. 2014. &lt;http://

www.jointcommission.org/core_measure_sets.aspx&gt;.

Web. 12 Dec. 2014. &lt;http://www.cms.gov/Regulations-and-Guidance/Legislation/

EHRIncentivePrograms/Downloads/2014_CQM_AdultRecommend_CoreSetTable.pdf&gt;.

What Is "Meaningful Use”?" What Is "Meaningful Use"?Web. 12 Dec 2014. &lt;http://www.hrsa.gov/healthit/meaningfuluse/MU Stage1 CQM whatis.html