Opinion

Getting a Head Start in the Quality Game

With the growing interest in quality and value across the health care delivery system, a new process is evolving. Specialty societies are partnering with universities and organizations like the National Quality Forum (NQF) to develop metrics in nearly every area of practice with the goal of finding gaps in care and working to fill them and improve quality across the system. In fact, right as Congress wrapped-up its year-end funding package and others in Washington headed out of town for the holidays, the National Quality Forum (NQF) and the Centers for Medicare and Medicaid Services (CMS) began an annual process that marks the beginning of quality policymaking for 2015.

On December 1, 2014, CMS sent a list of 202 Measures Under Consideration (MUC) for potential adoption in programs to the NQF Measures Applications Partnership (MAP). MAP began this process in 2011, following implementation of the Affordable Care Act. The most recent draft of recommendations, released on December 23, 2014, marks the fourth year of this pre-rulemaking recommendation cycle. Each year, MAP is tasked with evaluating the utility of quality measures in specific federal programs. For example, if CMS wants to begin focusing on an area of healthcare like colon cancer, CMS can propose several quality measures related to colon cancer screening and patient visits for potential inclusion in hospital and physician quality programs. After MAP receives the list from CMS, the public-private partnership breaks into workgroups and hammers out a draft report outlining support or concerns with  moving forward on the inclusion of proposed quality measures in federal healthcare programs. MAP offers a public comment period before publishing the final recommendations. CMS can refer to the report to determine selection of quality measure in the next year’s rulemaking cycle, but CMS is not bound by them. Regardless, the report is an early sign of potential quality proposals in future rulemakings.

For example, in this year’s programmatic deliverable report, MAP has suggested a focus on patient and family-centered care where fewer measures have been available in the past. Specific gaps in this area include person-centered communication, shared decision making, advanced illness care, quality of life and functional status, and cross-cutting themes (or how similar measures can be used across care settings and programs). These suggestions are just a small part of the recommendations outlined by MAP in the draft recommendations.

By sifting through the MUC and the MAP draft recommendations, professionals in the health care industry can get an early look at movement in health care quality programs for the upcoming year. As CMS moves to streamline quality measurement across federal programs and use measures more representative of patient outcomes, stakeholder input has become increasingly important. It is always better to get to the table as early as possible, and the quality table for 2015 is already being set. Without getting an early seat, some stakeholders may find themselves missing the meal entirely, or worse, on the menu. Interested parties should visit MAP’s webpage (HERE), read through the draft recommendations, and consider commenting on relevant measures. Even if not submitting comments, the MUC list provides a nice preview for what may appear in quality reporting programs in this year’s proposed rules. The current MAP draft recommendations are open for public comment until January 13, 2015.

 

Jeffrey J. Kimbell is the founder and President of Jeffrey J. Kimbell & Associates. Brett Meeks is the Manager of Government Affairs & Health Policy at the firm.