Standardizing measurement of health care quality

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Standardizing measurement of health care quality

The Centers for Medicare and Medicaid Services (CMS) recently announced a new agreement to standardize measures of health care quality. We applaud this announcement. The more organizations that can align around a common set of quality measures, the clearer the market signal will be regarding purchaser and payer expectations for performance on key indicators.

The agreement—which outlines seven sets of quality measures intended to be used across public and private payers—is the first to be announced by the Core Quality Measures Collaborative. The Collaborative includes CMS, America’s Health Insurance Plans (AHIP), the American Academy of Family Physicians (AAFP) and the National Partnership for Women and Families (NPWF). The announcement is timely for many as industry stakeholders and policymakers across the country try to figure out how to identify and reward high-quality health care. In Washington, however, we are ahead of most and have already approved a common measure set in 2014 and published the first results of that measure set in 2015.

How do Core Quality Collaborative measures compare to Washington’s Common Measure Set?

We compared measures from the Core Quality Measures Collaborative that pertain to “Accountable Care Organizations (ACOs), Patient Centered Medical Homes (PCMH), and Primary Care” to measures in the Washington State Common Measure Set. Download the comparison here.

The Washington State Common Measure Set includes 12 of the 21 measures included in the Core Quality Measures Collaborative measure set for ACOs, PCMHs and primary care. Seven of the nine measures that are not included in the Common Measure Set require electronic sharing of data from Electronic Health Record or provider self-report with audit in order to conduct measurement. At this time, a robust system to support aggregation of clinical data for measurement and reporting does not yet exist in Washington state, but it is a key focus of the Analytics, Interoperability, and Measurement (AIM) work under the Healthier Washington initiative.

The Core Quality Measures Collaborative also released six other measurement sets that are not included in this comparison; these measures are focused on care primarily delivered by specialists. The measures in these six modules tend to be more clinically specific and many or most of them apply to a relatively smaller subset of the population, making public reporting of results more challenging.

  1. Cardiology (31 measures, 1 measure overlaps with the ACO/PCMH/Primary Care set and this is in the Washington Common Measure Set; one additional measure does not overlap with the ACO/PCMH/Primary Care set, but is in the Washington Common Measure Set)
  2. Gastroenterology (8 measures)
  3. HIV and Hepatitis C (8 measures)
  4. Medical Oncology (14 measures)
  5. Obstetrics and Gynecology (11 measures, 3 overlap with the ACO/PCMH/Primary Care set and are in Washington’s Common Measure Set)
  6. Orthopedics (3 measures)

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