Aligning Quality Measure Sets – Successful Use of Online Measure Selection Tool with 2015 Updates...
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Aligning Quality Measure Sets – Successful Use of Online Measure Selection Tool with 2015 Updates Gerry Shea, Michael Bailit, Christine Hughes, and Susan
Aligning Quality Measure Sets Successful Use of Online Measure
Selection Tool with 2015 Updates Gerry Shea, Michael Bailit,
Christine Hughes, and Susan Schow February 24, 2015
Slide 2
Welcome and Introduction 2 Gerry Shea Buying Value Project
Director [email protected] 202 256-7577
www.buyingvalue.org
Slide 3
Asking Questions Due to the number of participants, we will not
open the telephone lines for questions. Please use the webinar
Q&A feature instead to ask questions. Roll over the green bar
at the top of the page and left click on Q&A or Chat. Type your
question in the box. Click on All Panelists in the Ask box. 3
Slide 4
The Buying Value Project Buying Value is an RWJF-funded
initiative of private health care purchasers employers, leading
business health organizations, and union health funds that was
launched in 2012. Mission Private purchasers contribute to better
health and lower health costs by buying on value rather than on
volume. Objective Enable widespread adoption of value purchasing in
the private sector through alignment of measures among private
purchasers and with federal and state public programs Strategy
Measure Alignment Campaign Public and private purchasers, health
plans, providers, and care delivery systems commit to core measure
sets developed through multi-stakeholder consensus processes
nationally, and at the regional or state level. Help for
States/Other Stakeholders in Creating Aligned Measure Sets Online
Measure Selection Tool and hands-on help. 4
Slide 5
Buying Value Milestones Website www.buyingvalue.org (2012) --
Basic info on value- purchasing Primer, Legal Memo on Anti-Trust
Issueswww.buyingvalue.org Starter Core Measure Set (March 2013)
National purchasers, consumers, CMS & payers (health plans)
Study of 48 Measure Sets in Use at State Level (2013) -- Only 20%
of measures used by more than one program; 25% of shared measures
modified in some way; 39% of measures either non-standard or
homegrown Model for Consensus Core Measure Sets -- A
multi-stakeholder, two-tier (national and regional or state)
process for consensus core measure sets Online Measure Selection
Tool (9/2014; Updated 1/2015) web-based spreadsheet linked to
measure databases that enables those creating measure sets to view
in one place a multitude of important decision factors. 5
Slide 6
The State of (Mis)Alignment 6 2013 Buying Value study of state
quality measure sets: Only 20% of measures used by more than one
program 23% of shared measures modified in some way 39% of measures
non-standardized or homegrown The result? Tremendous variation in
the way we define and evaluate quality across the country.
Slide 7
Measure Alignment Work: Federal Agencies To Cut 94% of Measures
in Seven Key Areas! 7 7
Slide 8
Other Measure Alignment Work CMMI State Innovation Model (SIM)
Grants 38 states & $1 billion in federal funds to develop &
test innovative payment and service delivery models in public
programs for use in statewide multi-payer programs with aligned
measure sets. IOM Committee on Core Metrics for Better Health at
Lower Costs Report originally due in fall, 2014 Now expected late
February Commercial Measures Alignment Project AHIP initiative,
staffed by NQF, to align measures with CMS Report originally
expected in fall, 2014 8
Slide 9
Presenters 9 Michael Bailit President Bailit Health
[email protected] Christine Hughes Senior Consultant Bailit
Health [email protected]
Slide 10
How to Build a Measure Set 10
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Slide 14
2015 Buying Value Measure Set Updates Updates to the following
federal measure sets: January 2015: Core Set of Childrens Health
Care Quality Measures for Medicaid and CHIP (Child Core Set) Core
Set of Health Care Quality Measures for Adults Enrolled in Medicaid
(Medicaid Adult Core Set) Physician Quality Reporting System (PQRS)
for 2015 (entire list) EP EHR Incentive Clinical Quality Measures
(eCQMs)(for 2015) Cross-cutting Measures November 2014: CMS
Medicare Shared Savings Program (MSSP) ACO for 2015 CMS Medicare
Part C & D Star Ratings Measures Addition of multi-stakeholder
aligned measure sets from Maine and Washington 14
Slide 15
Demonstration of the Measure Selection Tool 15
Slide 16
Selected Organizations That Have Used the Measure Select Tool
Maine Health Management Coalition Vermont Green Mountain Care Board
Washington Health Alliance 16
Slide 17
Experience with the Buying Value Measure Selection Tool Susan
Schow, Maine Health Management Coalition 17
Slide 18
Use of the Buying Value Tool in Maine Susan Schow, MPH,
Healthcare Measurement Analyst
Slide 19
Maine Health Management Coalition | Maine Health Management
Coalition-Foundation 11 Bowdoin Mill Island, Suite 260 | Topsham,
ME 04086 | (207) 899-1971 | www.mehmc.org | www.getbettermaine.org
MHMCs Measure Alignment Efforts Accountable Care Implementation
Committees Work Group Established Align measures used for
Accountable Care Organization (ACO) payment and contracting Develop
multi-payer measure set aligned closely with CMS ACO measures
supplemented with pediatric and womens health metrics To minimize
reporting burden, initial phase will rely on claims-based measures
and available uniform survey results Identify outcomes measures for
adoption as reporting capabilities grow Establish protocol for
identification of pending measures (outcomes, functional status,
etc.)
Slide 20
Maine Health Management Coalition | Maine Health Management
Coalition-Foundation 11 Bowdoin Mill Island, Suite 260 | Topsham,
ME 04086 | (207) 899-1971 | www.mehmc.org | www.getbettermaine.org
Maines Measure Alignment WG Identified Ten Criteria for Measure
Inclusion: Current Feasibility Evidence-based and Scientifically
Acceptable Setting Free Usability / Adaptability Patient Experience
Has a Relevant Benchmark Financial / Incentivization Improving this
Measure will Translate into Significant Changes in Value Durability
Aligned with Other Measure Sets
Slide 21
Maine Health Management Coalition | Maine Health Management
Coalition-Foundation 11 Bowdoin Mill Island, Suite 260 | Topsham,
ME 04086 | (207) 899-1971 | www.mehmc.org | www.getbettermaine.org
Maines Measure Alignment WG How to evaluate or score each measure
with so many different criteria? Buying Value Tool allowed scoring
each measure as to how well it meets each criteria: Yes = 2 points
Somewhat = 1 point No = 0 points Summed points for each measure
Used tally to guide final review of draft measures for inclusion
Allows for adding comments to record decisions Made complex task
easy and documentable
Slide 22
Maine Health Management Coalition | Maine Health Management
Coalition-Foundation 11 Bowdoin Mill Island, Suite 260 | Topsham,
ME 04086 | (207) 899-1971 | www.mehmc.org | www.getbettermaine.org
Maines Measure Alignment WG Aligning with Other Measure Sets To
shorten the list being considered, needed to identify measures most
commonly used Many measures are similar but slightly different
(e.g., Optimal Diabetes Care and Comprehensive Diabetes Care) Tool
includes multiple federal measure set lists Allows inclusion of
relevant local commercial and state measure sets Tool counts the
highest overlap of reporting for identifying opportunities for
alignment
Slide 23
Q&A Roll over the green bar at the top of the page and left
click on Q&A or Chat. Type your question in the box. Click on
All Panelists in the Ask box. 23
Slide 24
For More Information and a Helpful Resource Buying Value
www.BuyingValue.org www.BuyingValue.org Bailit-authored brief
titled Considerations for State Development of Performance Measure
Sets www.rwjf.org/en/research-publications/find-rwjf-
research/2014/09/considerations-for-state-
development-of-performance-measure-sets.html
www.rwjf.org/en/research-publications/find-rwjf-
research/2014/09/considerations-for-state-
development-of-performance-measure-sets.html 24