Alignment needed between measures and national priorities
WASHINGTON – Nearly all healthcare organizations that use quality performance measures included measures endorsed by the National Quality Forum, according to a new study.
The NQF commissioned an independent report authored by the RAND Corporation evaluating how performance measures are currently being used in healthcare, by whom and for what purpose.
The report summarizes key barriers and facilitators to using measures; and identifies opportunities for maximizing standardized performance measure use moving forward.
RAND found that only 1 percent of organizations studied do not use any NQF-endorsed measures, which include public reporting, payment and network selection, accreditation and certification and quality improvement.
The evaluation was performed as part of a contract with the U.S. Department of Health and Human Services.
Janet Corrigan, president and CEO of NQF, said the report was created as a first step in better understanding and analyzing national use of performance measures in healthcare.
“This report is an important first step toward helping us gain a better, more systematic understanding of how NQF-endorsed measures are being used,” said Corrigan. “We are committed to examining where and how we can make the greatest impact in improving health and healthcare through priority setting, the increased use of performance measures, and meeting measurement gaps.”
Over the course of six months, RAND researchers conducted interviews with measure end-users—such as community collaboratives, health plans, state and federal government agencies and consumer groups—and performed a review of publicly available documents and materials from websites.
The surveyed organizations cited a number of internal and external factors driving their use of performance measures, such as legislative requirements related to quality-based payments and public reporting contained in the Patient Protection and Affordable Care Act. Others used the measures in response to local public health issues, such as obesity, or to help operationalize their individual missions.
The ability of data to construct measures was the single-most important cited factor as either facilitating or impeding the use of measures.
The respondents noted that NQF-endorsement or widespread use of a measure enhanced provider buy-in.
The organizations pointed out a number of areas where measure gaps exist, as well as areas where new specialty measures would be useful.
Interview participants also stressed the need for better alignment between measures used in the public and private sectors around national priorities, said Tom Valuck, MD, senior vice president of Strategic Partnerships at NQF.
“NQF is already invested in advancing a number of opportunities raised in the RAND study through the work of the NQF-convened National Priorities Partnership and Measure Applications Partnerships, the measure endorsement process, and tools to support frontline implementation,” said Valuck.
For example, NPP is establishing priorities and tracking alignment with the National Quality Strategy, while MAP is assessing the use of “best available” measure sets for payment and public reporting programs, said Valuck.
The measure endorsement process fills critical gaps and is looking to emphasize harmonization of measures to reduce provider burden and patient confusion, he noted.
Valuck said NQF’s new web-based tool, the Quality Positioning System, helps make NQF measures more accessible and, along with other community-oriented work such as the Community Tool to Align Measurement, has corroborated measure gap areas.