Breakout: Quality and Performance Measure WG
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1 Breakout: Quality and Performance Measure WG Maternal Immunization Sub-Group ESRD Sub-Group Adult Composite May 11, 2016 Atlanta, GA Co-Chairs: Amy Groom, IHS Sharon Sprenger, Joint Commission Sam Stolpe, PQA Angela Shen, NVPO HOW ARE MEASURES DEVELOPED? Identify focus/measure concept(s) Literature review/evidence review Expert input, e.g., Expert Advisory Panel Measure identification Measure specifications Public comment Testing Implementation NQF endorsement Most slides: shamelessly snagged from Stople pre-session yesterday on Quality National Adult and Influenza Immunization Summit 5/11/2016 1
2 NATIONAL QUALITY FORUM (NQF) The NQF is a nonprofit organization that operates under a three-part mission to improve the quality of American healthcare by: Setting national priorities and goals for quality improvement Endorsing national standards for measuring and Promoting the attainment of national goals through education and outreach NQF ADULT IMMUNIZATION COMMITTEE NQF Priorities for Measure Development 1. HPV catch-up for ages TDaP/Pertussis vaccine for ages Zoster vaccine for ages Zoster vaccine for ages Composite with other preventative services 6. Composite TDaP and flu for pregnant women 7. Composite Influenza, pneumococcal, Hepatitis B in diabetes 8. Composite Influenza, pneumococcal, Hepatitis B in ESRD 9. Composite Hep A and B in chronic liver disease 10. Composite of all AHIP vaccines for healthcare workers National Adult and Influenza Immunization Summit 5/11/2016 2
3 IZ METRICS IN FEDERAL PROGRAMS Measure # Programs Influenza 10 Hospital Inpatient Quality Reporting; Inpatient Rehabilitation Facility; Nursing Home Compare Measures; LTCH Quality Reporting; Home Health Quality Reporting; Medicare Shared Savings Program; Medicaid Adult Core; Health Insurance Marketplaces; Medicare Part C; ESRD QIP Flu Healthcare Professionals 5 Hospital Inpatient Quality Reporting; Outpatient Quality Reporting; Ambulatory Surgical Center Quality Reporting; Inpatient Rehabilitation Facility; LTCH Quality Reporting Pneumococcal 5 Hospital Inpatient Quality Reporting; PQRS; Nursing Home Compare Measures; Home Health Quality Reporting; Medicare Shared Savings Program Adolescent IZ Status 2 PQRS; Medicaid CHIPRA Childhood IZ Status 2 PQRS; Medicaid CHIPRA HPV in females 2 Medicaid CHIPRA; Health Insurance Marketplaces Influenza Screening 2 PQRS; Home Health Quality Reporting Hepititus A 1 PQRS Pneumococcal Screening 1 Home Health Quality Reporting Registry Submission Capability 1 Medicare and Medicaid HER Incentive: Meaningful Use Stage 2 Core COMPREHENSIVE OVERVIEW OF CMS QUALITY PROGRAMS Hospital Quality Physician Quality PAC Quality Payment Models Population Health Meaningful use EHR incentive Inpatient quality Outpatient quality Ambulatory surgical centers Readmission reduction program HAC payment reduction program PPS-exempt cancer hospitals Inpatient psychiatric facilities Meaningful use EHR incentive Physician Quality Reporting System (PQRS) Value-based Payment Modifier (VM) Maintenance of certification Inpatient rehabilitation facility Nursing Home Compare measures LTCH quality Hospice quality Home health quality Medicare Shared Savings Program (ACOs) Hospital valuebased purchasing Physician Feedback ESRD QIP Innovations Pilots Medicare Part C Medicare Part D Medicaid Adult Core Measures Medicaid Child Core Measures Health Insurance Exchange Quality Reporting System (QRS) National Adult and Influenza Immunization Summit 5/11/2016 3
4 QUALITY BONUS PAYMENTS The star ratings now affect payment to Medicare Advantage plans wherein higher-rated plans get higher payment Quality Bonus Payments (QBPs) are being awarded on a sliding scale according to star ratings 2016 payments will be based on 2015 ratings which are based on 2013 and 2014 data QBP opportunity for large MA-PDs (Humana, United Healthcare, Aetna/Coventry, CIGNA/HealthSpring) may exceed $100 million NAIIS QUALITY METRICS WORKGROUP Pregnancy Composite Metric Subgroup Measure consists of flu, TDaP Good overall progress ESRD Immunization Composite Subgroup Measure consists of flu, pneumo, Hep B Potential to work with ESRD QIP Adult Composite Metric Subgroup Successful adult measure developed by IHS (Tdap, pneumo, herpes zoster) Data sourcing challenges National Adult and Influenza Immunization Summit 5/11/2016 4
5 PREGNANCY COMPOSITE Measure consists of flu, TDaP Good overall progress draft measure specification to NCQA Where is it to land HEDIS? How do you ensure uptake into plans? NAIP IP deep dive Thoughts? ESRD COMPOSITE Measure consists of flu, pneumo, Hep B Potential to work with ESRD QIP Hepatitis B data draw down from CrownWeb things have changed since TEP in 2012 Flu measure KCQA follow up in Summer Immunization data into IIS in respective states - KCQA to follow up Follow up with AIRA? other ideas? DISCUSSION National Adult and Influenza Immunization Summit 5/11/2016 5
6 ADULT COMPOSITE Successful adult measure developed by IHS (Tdap, pneumo, herpes zoster) Flu? Data sourcing challenges NQF Incubator Project Optum Analytics Next steps YOU KNOW WHERE TO FIND US Non-Federal Sharon Sprenger, MPA, RHIA, CPHQ Joint Commission Federal Amy Groom, MPH Indian Health Service Samuel Stolpe, PharmD PQA Alliance Angela Shen, ScD, MPH National Vaccine Program Office Many thanks to Ernie Moy who recently left AHRQ & Michael Daley who supports this group. National Adult and Influenza Immunization Summit 5/11/2016 6
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