Healthcare leaders and experts are beginning a two-month process of scrutinizing and making recommendations on the 97 quality measures that the CMS is considering using for public reporting and payment initiatives next year.
These measures, little known to the public, influence not just the flow of billions of dollars in annual Medicare spending but also the way hospitals, nursing homes and other providers treat patients.
The Measure Applications Partnership, convened by the National Quality Forum and charged with overseeing this review process, consists of several workgroups, including hospitals, clinicians, post-acute and long-term care and dual-eligible beneficiaries. They consider quality measures specific to those providers, settings or populations and make recommendations to the CMS on prioritizing and aligning those measures.
The first meeting begins Thursday with the hospital workgroup. The clinician workgroup meets Dec. 12 and 13, the post-acute care and long-term care workgroup convenes Dec. 14 and 15, and the dual-eligible workgroup works through a coordinating committee.
The 97 measures that the CMS is considering, which run the gamut from unplanned hospital readmissions to alcohol use screenings, are used for a variety of purposes. When used for reporting requirements, they give providers feedback on the quality of their care. Those metrics are also used in the growing ratings platforms that CMS publishes, such as Hospital Compare, to provide patients with information to gauge the quality of facilities.
Medicare's quality payment initiatives, such as the Hospital Readmissions Reduction Program and the Medicare Access and CHIP Reauthorization Act, also use those metrics to determine how to pay hospitals and physicians on the basis of the quality, and not just the quantity, of services they provide to Medicare beneficiaries.
The workgroups consist of public and private stakeholders. Their job is to provide HHS with pre-rulemaking guidance that better coordinates various measures across different providers and populations.
The Measure Applications Partnership has until Feb. 1, 2017, to deliver its final recommendations to HHS.