How will the private sector interact with the Federal government to coordinate the selection of value-driven health care measures?

September 20, 2009 by admin

Currently, the private sector and the Federal government rely heavily on the NQF-endorsement process to identify potentially useful quality measures. To promote effective adoption and use of these measures without undue administrative burdens on providers, broad-based national stakeholder groups, such as the AQA and the HQA (in which the Federal government is involved) have adopted subsets of NQF-endorsed measures for hospital and physician measurement efforts.In the case of the HQA, CMS is using those measures to meet the Congressional directive for hospitals to report on a set of quality measures to receive their full annual update payments. This process has helped to unify both Federal and private sector provider quality measurement efforts. For example, because the data on the "Hospital Compare" Web site is all-payer data on widely accepted hospital clinical quality measures, it can be used by all employers to measure the quality of care across hospitals. CMS plans to continue to support these broad-based national collaborative efforts to endorse and adopt measures and to report on quality and encourage employers to use data from these efforts.In addition, the BQI project will be using quality measures that were adopted by AQA and HQA and endorsed by NQF. Employers can help the effort by actively participating in these initiatives. For example, employers can become members of the NQF, which is playing a key role in defining the national consensus performance measurement set, and can provide input into the AQA or HQA processes. As part of this effort, employers also are encouraged to closely monitor and use standard measures adopted by the AQA and HQA, which are playing a key role in driving the implementation of standard measures for physicians and hospitals, and to encourage the AQA or HQA processes to promote the national adoption of additional measures as consensus develops. Employers are also encouraged to participate in regional public-private collaboratives and provide input into measure implementation, as well.