The U.S. Department of Health and Human Services (HHS) announced in January that its target is to have “30% of Medicare payments tied to quality or value through alternative payment models by the end of 2016, and 50% of payments by the end of 2018.” Accountable care organizations—in which health care providers are accountable for the quality and cost of the care they deliver to patients—are among the programs targeted for this value-based payment expansion, and their payments will likely be tied to quality measures.
Given the HHS mandate, it’s clear that measuring the quality and cost of health care is an integral part of accountable care, but it also will be important to shed light on gaps in measurement and missed opportunities to promote improvement in patient care and health systems. That’s why the National Pharmaceutical Council (NPC), working with Discern Health and health care thought leaders, undertook research to examine measurement gaps and offer solutions for addressing those gaps, particularly for specialty care and innovative treatment.
Discern Health Partner Dr. Tom Valuck outlines the key findings from that research, noting that an important step is to overcome barriers to the use of quality measures, such as finding data sources and efficiently collecting measure information, and using feedback loops to understand an organization’s progress. He also says that selecting the most impactful measures, such as clinical, cross-cutting and patient-reported outcomes, can improve measure sets for accountable care programs.
Dr. Valuck says that measures should be fit for purpose; using a layered approach to measurement, or one in which different, but related, measures are used at the population, system and provider levels can help to form a larger picture of quality for an organization.
It isn’t possible to accurately assess outcomes for certain types of patients, especially cancer patients who might have more individualized treatments that are not easily measured. In those situations, Dr. Valuck suggests using a modular approach to quality measurement, in which specific subpopulations would be identified to allow for a more granular view of quality and costs for that group.
Dr. Valuck emphasizes that simply adding more measures to fill quality gaps is not the solution. Instead, he encourages a more strategic, targeted approach toward addressing quality measurement challenges.
Dr. Valuck will join NPC on February 26 at 12:30 pm ET for a webinar, “Mind the Gap: Improving Quality Measurement in Accountable Care Systems,” to discuss the research and potential solutions to quality measure gaps. In addition, Dr. Kate Goodrich, director, Quality Measurement and Health Assessment Group, Centers for Medicare and Medicaid Services, will provide insight into how CMS identify priorities for measurement and work with stakeholders to address measure gaps, and Dr. Mark McClellan, director, Health Care Innovation of Value Initiative, Brookings Institution, will discuss how accountable care systems can use quality measures to balance financial incentives. Kimberly Westrich, vice president, health services research, NPC, will moderate the discussion.