Gerry Shea Michael Bailit Christine Hughes and Susan Schow February 24 2015 Welcome and Introduction 2 Gerry Shea Buying Value Project Director gsheabuyingvalueorg 202 2567577 wwwbuyingvalueorg ID: 611754
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Slide1
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, 2015Slide2
Welcome and Introduction
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Gerry Shea
Buying Value Project
Directorgshea@buyingvalue.org202 256-7577www.buyingvalue.orgSlide3
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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.
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Buying Value Milestones
Website
www.buyingvalue.org
(2012) -- Basic info on value-purchasing – Primer, Legal Memo on Anti-Trust Issues“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.
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The State of (Mis)Alignment6
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. Slide7
Measure Alignment Work: Federal Agencies To Cut 94% of Measures in Seven Key Areas!
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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 CostsReport originally due in fall, 2014
Now expected late FebruaryCommercial Measures Alignment ProjectAHIP initiative, staffed by NQF, to align measures with CMSReport originally expected in fall, 2014
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Presenters
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Michael Bailit
President
Bailit Health mbailit@bailit-health.com
Christine Hughes
Senior Consultant
Bailit Health
chughes@bailit-health.com
Slide10
How to Build a Measure Set
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2015 Buying Value Measure Set Updates
Updates to the following federal measure sets:
January 2015:
Core
Set of Children’s 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 MeasuresNovember 2014:CMS Medicare Shared Savings Program (MSSP) ACO for 2015CMS Medicare Part C & D Star Ratings MeasuresAddition of multi-stakeholder aligned measure sets from Maine and Washington
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Demonstration of the Measure Selection Tool
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Selected Organizations That Have Used the Measure Select ToolMaine Health Management Coalition
Vermont
Green Mountain Care
Board
Washington Health Alliance16Slide17
Experience with the Buying Value Measure Selection Tool
Susan Schow, Maine Health Management Coalition
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Use of the Buying Value Tool in Maine
Susan Schow, MPH, Healthcare Measurement AnalystSlide19
MHMC’s Measure Alignment Efforts
Accountable
Care Implementation Committee’s 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 women’s health metrics
To minimize reporting burden, initial phase will rely on claims-based measures and available uniform survey resultsIdentify outcomes measures for adoption as reporting capabilities grow
Establish protocol for identification of “pending” measures (outcomes, functional status, etc.)Slide20
Maine’s Measure Alignment WG
Identified Ten Criteria for Measure Inclusion:
Current Feasibility
Evidence-based and Scientifically Acceptable
Setting Free
Usability / AdaptabilityPatient Experience
Has a Relevant Benchmark
Financial / Incentivization
Improving this Measure will Translate into Significant Changes in Value
Durability
Aligned with Other Measure Sets Slide21
Maine’s 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 pointsSummed 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 documentableSlide22
Maine’s 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 listsAllows inclusion of relevant local commercial and state measure setsTool counts the highest overlap of reporting for identifying opportunities for alignment Slide23
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Type your question in the box.
Click on “All Panelists” in the
“Ask” box.
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For More Information and a Helpful Resource
Buying Value
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
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