Healthcare Business News
Margaret O’Kane, NCQA president

New NCQA tool to assess diabetes, heart care

By Maureen McKinney
Posted: April 9, 2013 - 3:45 pm ET

The National Committee for Quality Assurance says it is developing a new outcomes-based measurement tool aimed at more accurately assessing the care delivered to patients with heart disease and diabetes.

In a Tuesday news release, Washington-based NCQA, well-known for its performance measure set for health plans and for its patient-centered medical home program, said the tool will extract electronic health-record data to provide a more complete picture of how patients' risks of adverse outcomes are reduced, based on individualized treatment.

NCQA is co-developing the measurement tool, known as the Global Cardiovascular Risk Score, with Archimedes, a healthcare modeling and analytics firm headquartered in San Francisco. The project is funded by a grant from the Robert Wood Johnson Foundation.

Margaret O'Kane, NCQA's president, said the tool could eventually be adopted for use by the CMS and private payers.

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“Its widespread adoption could have a profound impact on healthcare costs because it assesses how well providers engage in prevention and goal-setting for their high-risk patients,” O'Kane said in the release. “We believe it could become the new gold standard of quality measurement, replacing some traditional measures that have been the cornerstone of quality improvement for years.”

NCQA is one of many organizations attempting to shift focus from process-of-care measures and toward metrics that gauge patient outcomes, particularly as research points to scant evidence of a strong link between process measures and improved quality of care.

For next year's version of its value-based purchasing program, which rewards or penalizes hospitals based on their performance on set metrics, the CMS is including a mortality measure that gauges 30-day death rates for heart attack, heart failure and pneumonia. And in 2015, the agency will also include a spending-per-beneficiary measure, which will be given a weight of 20% toward hospitals' overall value-based purchasing score.

But NCQA said its measurement tool is different because it will be designed to draw upon a variety of data sources to assess patients' overall disease outcomes.

“Unlike current measures, which focus on a particular process or biomarker, the GVCR measure is a single metric that captures what every provider can do to prevent adverse outcomes, all integrated in a medically and clinically realistic way,” the group said in the release.

NCQA said it's currently recruiting healthcare organizations and expects to report findings by summer 2014.

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