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Statewide common measures set now open for public comment

In June 2014, Washington State Governor Jay Inslee appointed a diverse group of leaders to serve on the Performance Measures Coordinating Committee (PMCC) to recommend standard statewide measures of health performance to inform public and private health care purchasing, as well as propose targets to track costs and improvements in health outcomes.

The committee, along with members of three technical work groups, have been working together to identify measures for the new Statewide Standard Core Set of Performance Measures.

A final draft list of starter measures was presented to the PMCC last week. These draft measures are now open for public comment.

The committee will finalize the set of measures on December 17, 2014.

Find the recommended measures set on the Healthier Washington website in a document titled Measures Set Final Work Group Recommendations.

After reviewing the recommendations, you can provide feedback through a survey. To be considered, all survey feedback must be received by 5:00 pm on Friday, November 21, 2014.

Thank you for your interest in the development of the Statewide Core Measures Set and for helping make Washington a healthy place to live, work and play!

Published: November 7, 2014

About Washington Health Alliance

The Washington Health Alliance is a place where stakeholders work collaboratively to transform Washington state’s health care system for the better. The Alliance brings together organizations that share a commitment to drive change in our health care system by offering a forum for critical conversation and aligned efforts by stakeholders: purchasers, providers, health plans, consumers and other health care partners. The Alliance believes strongly in transparency and offers trusted and credible reporting of progress on measures of health care quality and value. The Alliance is a nonpartisan 501(c)(3) nonprofit with more than 185 member organizations. A cornerstone of the Alliance's work is the Community Checkup, a report to the public comparing the performance of medical groups, hospitals and health plans and offering a community-level view on important measures of health care quality (www.wacommunitycheckup.org).

4 Responses to “Statewide common measures set now open for public comment”

  1. kim pittenger, MD

    Concerning avoidance of antibiotics for acute bronchitis: Our effort to improve performance via prescribing feedback and academic detailing was associated with a rapid coding shift. Codes for acute bronchitis fell and codes for cough rose. VM fell off the WSHA metric due to too few coded visits for acute bronchitis. We therefore developed a code cluster for URI of all kinds to reduce abx prescribing for all forms of URI substantially. Current WSHA acute bronchitis metric may not be capturing the event we are all trying to improve. Have you seen a decline in acute bronchitis code volumes?

    Reply
  2. Emily Inlow-Hood, Washington Health Alliance

    Interesting finding. When did you notice this shift?

    Our data aggregation vendor runs these measure results for us. At the Alliance we don’t have access to the actual codes that were used or the claims to see why the denominators shift across time periods, but we did notice a 32% drop in the denominator between the first year of our reporting on this measure and the subsequent year (services provided between 7/1/2008 – 6/30/2009). This could be due to a drop in the use of the codes to capture bronchitis, but we can’t confirm whether this was due to a shift in coding practices for this time period.

    Reply
  3. Gary S. Kaplan, MD

    Director Teeter and Ms. Dade,
    On behalf of Virginia Mason, we submit the following comments on the Recommendations for Statewide Common Measures for standard Washington health performance measures, which will inform public and private health care purchasing, track costs and improve health care outcomes.

    Virginia Mason continues to be a strong supporter of the state’s efforts to improve health care delivery in Washington. At Virginia Mason, we are committed to transforming health care, providing the highest quality and safest care at a sustainable cost. We continually work to reduce waste, decrease costs and increase the quality of care for our patients. We hope that the state will continue its efforts to tie performance measures to outcome in order to improve quality and efficiency, eliminate waste and lower cost. We believe that the recommended performance measures are a beneficial, desirable step in helping to achieve these goals.

    We were pleased that the Performance Measures Coordinating Committee (PMCC) included Dr. Craig Blackmore, Virginia Mason Director for Health Services Research and a member of the Washington State Health Technology Clinical Committee. As the work of the state proceeds, we are committed to further partnering with the Health Care Authority, other state agencies and the Washington Health Alliance in tracking costs and improvements in health outcomes in Washington.

    Overall, we are very supportive of the 53 proposed measures recommended for inclusion in the state’s “starter set” of measures. We commend PMCC’s identification and proposed use of existing measures rather than attempting to create new measures. In the future, as the state’s health care priorities evolve and changes occur in evidence-based care, applicable measures also should evolve for use in the state.

    We also submit the following comments concerning specific measures:

    Measure #29 – Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis
    As to the avoidance of antibiotics for acute bronchitis, we note that comments have been submitted to the PMCC by Kim Pittenger, MD concerning Virginia Mason’s recent experience: “Our effort to improve performance via prescribing feedback and academic detailing was associated with a rapid coding shift. Codes for acute bronchitis fell and codes for cough rose. VM fell off the WSHA metric due to too few coded visits for acute bronchitis. We therefore developed a code cluster for URI of all kinds to reduce abx prescribing for all forms of URI substantially. Current WSHA acute bronchitis metric may not be capturing the event we are all trying to improve.”

    Based on Dr. Pittenger’s comments, we would hope that use of a performance measurement for avoidance of antibiotics will accurately address the event that the state is working to improve.

    Measure #40 – Medications: Percent Generic
    Experience across the state and at Virginia Mason indicates that Washington already is at a high level of prescribing of generics; the state averages more than 87.6 percent. Moreover, the state already has several programs in place to promote the prescribing of generics. We question whether the inclusion of the proposed measure will enhance health care delivery.

    We concur with the comments of the Washington State Hospital Association (WSHA) that once the starter set of measures is finalized, the state should be cautious as to the use of measures “where there may be low volume and could potentially be misleading in reports.” We are gratified that PMCC and the Health Care Authority have agreed to further discussions on how measures with low volume will be used.

    Virginia Mason appreciates the opportunity to provide comments and looks forward to continuing working with you on these issues. If you have questions concerning our response, please contact me; Ross Baker, public policy director (Ross.Baker@virginiamason; 206.550.1094); Kathleen Paul, vice president of communications and public policy (Kathleen.paul@virginiamason.org; 206.341.0439), or Dr. Blackmore (craig.blackmore@virginiamason.org, 206.625.7183).

    Reply
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