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Tag Archive | "NQF"

NQF Releases Reports on HIT Use

The National Quality Forum (NQF) released two reports this morning related to the effective use of health information technology (HIT).

The report, “Driving Quality—A Health IT Assessment Framework for Measurement,” examines, defines, and organizes the data needed to measure effective health IT use to better understand how health IT tools can improve the efficiency, quality, and safety of healthcare delivery.

NQF’s report on “Driving Quality and Performance Measurement—A Foundation for Clinical Decision Support” details the Forum’s Clinical Decision Support Taxonomy, which is composed of four functional categories that classify and categorize the CDS information necessary for quality improvement: 1) triggers, 2) input data, 3) interventions, and 4) action steps. The NQF CDS Taxonomy provides a foundation for the description of an electronic infrastructure, bridging quality measurement and health IT. Specifically, the taxonomy will enable quality measure developers, clinical system implementers, and vendors to be more effective in developing, sharing, implementing, and evaluating the effectiveness of different approaches to applying CDS aligned with quality measurement.

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Capital Thinking Podcast

After a solemn week in the House of Representatives devoted to recognizing and remembering the victims of the Arizona shootings, the White House has instructed that Congress get back to work and on with its legislative business.  Therefore, Majority Leader Eric Cantor announced that the House will resume “thoughtful consideration” of the health care reform repeal bill this week.  Beginning Tuesday, seven hours of debate will be allowed on the bill with the final vote to occur on Wednesday.  The rules will also allow for one Democratic amendment by Rep. Jim Matheson (D-UT) that would provide for a permanent fix to Medicare’s sustainable growth rate formula, preventing dramatic cuts in physician reimbursements under Medicare.  Congressional Democrats were vocal in their opposition to the repeal bill, noting that it would eliminate important consumer protections, leave millions without insurance, and add to the deficit. Preliminary analysis by the Congressional Budget Office supported this position by determining that repealing the overhaul bill would cost $230 billion over ten years.  It is largely expected to pass due to the Republican majority, but will likely not gain any traction in the Senate.  On Thursday, House Republicans plan to bring up their bill instructing the committees to draft replacement legislation.  Committee organization is also expected to resume, and announcements on Democratic Members’ placement on Committees and subcommittees should be announced this week.

Analysis from the Institute of Medicine’s public meeting last week on what constitutes the definition of “essential benefits” is expected to be a hot topic.  The health reform law required that the IOM analyze and develop criteria for a definition of benefits that all plans sold through an insurance exchange will have to offer.  The IOM will likely publish a report of its findings in September.  However, the process is still in its early stage.  The Bureau of Labor and Statistics is required to find out what the typical employer-sponsored health plan covers, while the Department of Health and Human Services will ultimately determine the final definition.

Last week the Medicare Payment and Advisory Commission (MedPAC) finalized its recommendations for its upcoming March report to Congress.  Of note, the Commission voted to recommend to Congress that inpatient and outpatient Medicare hospital payments rise by 1 percent in fiscal 2012, that payment rates under the physician fee schedule should increase by one percent, and backed a first-ever co-pay for home health care services, despite concerns about the financial burden it might affect beneficiaries.  Chairman Glenn Hackbarth noted that there is ample evidence that the use of co-pays deter over-use of a service. Home health use has increased by 50 percent since 2001 and Medicare spent $19 billion on home health services in 2009. 

Finally, it is also important to note that the National Quality Forum (NQF) has opened a Call for Nominations for organizations and individual subject matter experts to serve on the advisory workgroups of the Measure Applications Partnership (MAP).  MAP will provide recommendations to the Department of Health and Human Services on selecting measures for public reporting and performance-based payment programs.

The multistakeholder workgroups will advise the MAP Coordinating Committee on quality issues and the use of measures to encourage improvement for specific care settings, care providers, and patient populations.  Although the workgroup structure will need to be flexible to respond to the needs of HHS, NQF anticipates the potential for as many as four advisory workgroups in the following areas: clinician, hospital, post-acute care/long-term care, and dual eligible beneficiaries. All nominations must be submitted by Monday, February 7, at 6:00 pm ET.

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NQF: The Role of Health Information Technology in Quality Improvement

On June 17, 2010, the National Quality Forum (NQF) hosted a webinar focused on the intersection of health information technology (HIT) and quality improvement.

Dr. Marc Overhage, MD, PhD, Director of Medical Informatics at Regenstrief Institute, reviewed the goal of the Health Information Technology for Economic and Clinical Health Act (HITECH) to improve care and the efficiency of care. He stated that the key to HITECH is the definition of “meaningful use.”  He reported that the Centers for Medicare and Medicaid Services (CMS) is close to issuing its final rule that will establish the definition of meaningful use. He speculated that the Agency will soften the definition of meaningful use in the final rule, but that the proposed and final rules will be very similar. He stated that the Agency’s goals in 2010 are data capture and sharing.  In 2013, the goal is increased data use to improve the quality of care and in 2015 CMS intends to focus on substantially improving outcomes for patients.

Dr. Overhage described the incentives established in HITECH to encourage physicians to become meaningful users of EHRs.  He stated that the EHR adoption timeline is constructed in a graduated incentive model and that the Federal government hopes that many providers will adopt EHRs early.  He noted that if providers become meaningful user in 2011 and 2012, they will receive the full incentive payment.

He highlighted the connection between the National Priorities Partnership priorities and the health outcomes policy priorities established in HITECH. He reported that patient and family engagement, population health, safety, and care coordination were common themes. The National Priorities Partnership also identified palliative and end-of-life care and overuse as additional priorities.

Dr. Overhage shared that Regenstrief has established a Quality Health First® Program that uses HIT to drive performance measurement and quality improvement. The program has incorporated a Medicare demonstration program, which allows Medicare providers to participate along commercial providers and provide incentives.  He explained that providers receive incentive payments based upon their own quality improvement, even if they are the worst performing among providers. In 2009, a 5 percent improvement in quality was reported across the 1,000 primary care providers.

He stated that NQF is convening the HIT and Quality Committees to: (1) help build the electronic infrastructure to help automate performance measurement; (2) encourage and harmonize information standards; (3) facilitate coordination between quality and HIT communities; and (4) establish quality measurement and clinical decision support to occur in simultaneous fashion.

NQF will host another webinar on July 16 at 12:00 pm Eastern Time focused on quality and leadership.

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NQF Seeks Comments on Partnership for Applying Measures to Improve Quality

The National Quality Forum (NQF) has requested public and member comments on its plan to establish a Partnership for Applying Measures to Improve Quality.  If the Secretary of Health and Human Services (HHS) assigns NQF with the responsibility to convene multi-stakeholder groups to provide input to the Secretary on the selection of new quality measures as required by the Patient Protection and Affordable Care Act, NQF will proceed with establishing the Partnership.

NQF envisions that the Partnership would provide input regarding Hospital Compare, the Physician Quality Reporting Initiative (PQRI), the hospital readmissions reduction program, the payment adjustment for hospital acquired conditions, measures for demonstrations (medical homes, accountable care organizations, bundled payments), and public reporting websites.

Any stakeholder who is interested in the quality provisions of the health reform law should take the opportunity to provide NQF with comments, which are due to NQF by June 15, 2010 at 6:00 pm Eastern Time.


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