A large group of healthcare industry stakeholders has released new quality measures to make the reporting process easier for providers and to better support evolving value-based payment mechanisms.
The intent is to agree on common core performance measures that will accurately describe quality in a way that is useful to all stakeholders in the industry. Having one set of standard descriptors is expected to reduce administrative burdens on clinicians and lessen confusion for consumers who use the data.
Participants in the effort, called the Collaborative, include America’s Health Insurance Plans, the Centers for Medicare and Medicaid Services, the National Quality Forum, physician associations, and consumer and employer groups. The seven new measures will cover accountable care organizations and medical homes for primary care, cardiology, gastroenterology, HIV/Hepatitis C, medical oncology, orthopedics, and obstetrics and gynecology.
The Collaborative will revise and maintain the core measure sets on an ongoing basis. New measures being considered by the American Academy of Orthopaedic Surgeons will come before the Collaborative for consideration later this year, according to a Frequently Asked Questions document available here.
CMS will go through its rule making processes to adopt measures it currently does not use, and private health plans will phase-in the measures. “Such a phase-in will be determined by certain specific factors,” according to the FAQ. “Contracts between physicians and private payers are individually negotiated and therefore come up for renewal at different points in time depending on the duration of the contract. Private payers will therefore implement these core sets of measures as and when contracts come up for renewal or if existing contracts allow modification of the performance measurement set.”
There will be steps that clinicians must follow in adopting the measures; several require clinical data that is extracted from electronic health records systems or data registries. “While some plans and clinicians may be able to exchange certain clinical data, a robust infrastructure to collect data on all the measures in the core set does not exist currently,” the FAQ notes.
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