WASHINGTON – The Measure Applications Partnership (MAP), a public-private partnership convened by the National Quality Forum, released two reports on Tuesday that pointed to specific opportunities for more coordinated approaches to making healthcare safer and enhancing clinical performance.

MAP was created for the explicit purpose of providing input to the Department of Health and Human Services on the selection of performance measures for public reporting and performance-based payment programs. It comprises more than 60 organizations representing major stakeholder groups, 40 individual experts and nine federal agencies. 

As part of a series to be submitted to HHS outlining MAP’s work, the two reports released Oct. 4 focus on:

• An ideal coordination strategy for HHS and the broader field on aligning performance measurement and other approaches for addressing hospital-acquired conditions and readmissions for all patients, regardless of who ultimately pays for their care; and

• An ideal coordination strategy for HHS on federal clinical performance measurement, with recommendations that would simultaneously accelerate improvement and a more cohesive system of care delivery because clinicians and the largest payer in the country will be focused on a select, targeted set of performance measures linked to achieving overall national aims for improved health and healthcare.   

The report, "Readmissions and Healthcare-Acquired Conditions Performance Measurement Strategy Across Public and Private Payers," identifies three focus areas for connecting the dots between public and private efforts to reduce healthcare-acquired conditions and readmissions:

• The need for a national core set of safety measures that are applicable to all patients;
• The need to collect data elements necessary for calculating the measures in the safety core set on all patients, regardless of care setting, age, or who pays their healthcare bills; and
• The need to help public- and private-sector entities coordinate their efforts to make care safer; shared “carrots” or incentives are key.

“This report points to a number of immediately actionable items that would make a significant difference in making care safer,” said George Isham, MD, co-chair of the MAP Coordinating Committee. “Collaboration, innovation and deliberate coordination across sectors will be key in achieving those steps.”

The report, Clinician Performance Measurement Coordination Strategy, first identifies characteristics of an ideal performance measure set for assessing clinician performance. These characteristics include:

• Alignment with National Quality Strategy priorities and high-impact conditions relevant to the program’s intended populations;
• Measures which are appropriate for use with the intended care settings and levels of analysis;
• An appropriate mix of measure types necessary for the specific program objectives;
• Longitudinal measures;
• Considerations for healthcare disparities, undesirable consequences, and efficient use of resources for data collection and reporting.

The report then advances measure selection criteria as a tool to evaluate and recommend measure sets for specific public reporting and performance-based payment programs. 

The group next evaluated the proposed Physician Value-Based Payment Modifier set against these characteristics and criteria, noting the absence of patient experience measures and a need for greater emphasis on healthy living, care coordination, affordability, safety and attention to disparities.

“The MAP report on clinician performance measurement creates important foundational work toward actual measure selection recommendations and identified specific steps that can reduce wasteful data collection burden, maximize meaningfulness of the information and accelerate improvement,” said Elizabeth McGlynn, co-chair of the MAP Coordinating Committee.

HHS has also requested that MAP provide multi-stakeholder input on performance measures to assess and improve the quality of care delivered to individuals who are eligible for both Medicare and Medicaid, known as "dual eligibles." The dual eligible beneficiary population includes many of the poorest and sickest individuals covered by both Medicare and Medicaid, frequently experiencing fragmented care and accounting for a disproportionate share of total health care costs.

In its initial phase of work regarding dual eligibles, MAP has developed a strategic approach to performance measurement and identified opportunities to promote significant improvement in the quality of care provided to these vulnerable populations. 

MAP will later further consider gaps in currently available measures and may propose new measure concepts for development.

A final report with MAP’s input on improving the quality of care delivered to individuals who are eligible for both Medicare and Medicaid is due to the Department of Health and Human Services on June 1, 2012.

“Adding private-sector voice to deliberations before measures are selected for public reporting and payment programs has great potential to streamline the federal rulemaking process and ensure both the public and private sectors are rowing in the same direction with respect to measuring and rewarding healthcare improvement,” said Janet Corrigan, president and CEO of the National Quality Forum. “NQF is pleased to serve as the neutral convener of this august group of heathcare leaders.”
 
To learn more about MAP, or to read the reports in their entirety click here.