What are we committing to regarding the selection and use of standardized quality measures for health care providers?

September 20, 2009 by admin

At the present time, the standardized quality measures most fully developed are those endorsed by the National Quality Forum (NQF) and adopted by the AQA (a multi-stakeholder group focused on physician quality measures) or the Hospital Quality Alliance (HQA). For the benefit of their employees, employers are encouraged to request that the health insurance plans, third party administrators, providers, and others with which they contract use and report standard performance measures for quality that are adopted by the AQA or the HQA. To the extent employers wish to measure the quality of care in additional areas not addressed by these sets of measures, they are encouraged to use measures endorsed by the NQF or approved by other national collaborations that include broad representation of providers and other key healthcare stakeholders. The current process, whereby the private and public sectors rely on the NQF to endorse measures and broad-based stakeholder groups to determine which ones to adopt, has helped to unify efforts to measure physician and hospital quality.Providers take a leadership role in all of these organizations and are integrally involved with the development of measures. The hospital measures are the result of years of research, the experience of CMS' hospital quality improvement program, and extensive input from hospitals. The physician AQA measures come from primarily two sources, the National Committee for Quality Assurance (NCQA) and the AMA-convened Physician Consortium for Performance Improvement. The Consortium is comprised of over 100 national medical specialty and state medical societies and expects to have a portfolio of 150 physician performance measures this Fall.Creating a uniform, consistent approach, including the use of common metrics, for quality measurement will align the interests of employers, health insurance plans, providers, and consumers to make informed decisions. Employers and plans will have the information necessary to provide higher value to their employees and enrollees. Provider efforts to improve quality will be more effectively focused, and they will have confidence in the measures used. And consumers will be able to make quality comparisons across providers and treatment options in order to make more informed decisions.