The NQF contended that questions about how quality measures will be used are the domain of its Measurement Applications Partnership, a multi-stakeholder group convened in 2011 to provide measurement feedback to HHS. The CMS has agreed not to include the measure in its soon-to-be-launched readmissions reduction program until the MAP group has reviewed it and provided recommendations for the measure's “optimal use,” the NQF added in the release.
In their appeal, the providers had also sharply criticized the NQF's consensus-reaching process, particularly in this case, when the measure was endorsed despite a lack of popular support among members. In response, the NQF said it will convene a task force that will look specifically at the consensus process and ways to improve it.
“We put great faith in our members and multi-stakeholder, expert committees to help us make decisions that are in the best interests of achieving a higher-value, safer healthcare system,” NQF President and CEO Janet Corrigan, in the release. “This current project shows that reaching consensus is difficult, but any process that balances multi-stakeholder interests yields important results.”
Amy Deutschendorf, Johns Hopkins Health System's senior director of utilization and clinical resource management, said she thought that the NQF had listened to the providers' concerns on the consensus process and on the measure's potential unintended consequences. Still, she said the group had hoped for a different outcome.
“We are disappointed that the measure was upheld even though it will not be attached to penalty at this time, because even publishing these kinds of outcomes on Hospital Compare leads to assumptions that may or may not be valid,” she said.
Deutschendorf says she hopes the MAP will include Johns Hopkins Health System in its review of the measure.
“We've been looking at readmissions on a case-by-case basis for more than a year and we really understand the risks and failures involved,” she added. “Providers need to feel comfortable that this is a measure we can really use to address performance improvement.”