NATIONAL CONSENSUS STANDARDS FOR PHYSICIAN PERFORMANCE: ROUND 1. Kenneth W. Kizer, M.D., M.P.H. President and CEO National Quality Forum
|
|
|
- Robert Hensley
- 5 years ago
- Views:
Transcription
1 NATIONAL CONSENSUS STANDARDS FOR PHYSICIAN PERFORMANCE: ROUND 1 Kenneth W. Kizer, M.D., M.P.H. President and CEO National Quality Forum August 22, 2005
2 Presentation Overview Provide some context for physician performance standards Provide an overview of the NQF Ambulatory Care PM Project: What has occurred to date? What is forthcoming?
3 THE IDEA OF HAVING STANDARDS FOR PHYSICIAN PERFORMANCE IS NOT NEW
4
5 The Quest for Healthcare Quality If a physician make a large incision with the operating knife and cure it,, he shall receive ten shekels in money. If a physician make a large incision with the operating knife, and kill him,, his hands shall be cut off. Code of Hammurabi, 1870 BC
6 TODAY S INCREASED ATTENTION TO HEALTHCARE QUALITY IS BEING DRIVEN BY AN UNPRECEDENTED CONFLUENCE OF FORCES
7 Healthcare Quality Improvement Driving Forces 1. Knowledge of deficiencies 2. Rising healthcare expenditures 3. Purchaser activism 4. Consumerism 5. Regulation and accreditation
8 A CROWDED FIELD Who are the players in the performance measurement and quality improvement game?
9 A partial list of the Alphabet Soup of PM/QI-Related Organizations JCAHO NCQA CMS IOM AHRQ FDA NQF CDC QIOs HQA GAO PCPI OPM NBCH ACQA Leapfrog MedPAC ACMQ IHI WBGH PBGH QUIC UHC ABMS
10 Lots of Signals.. BUT Little Direction
11 There is need for a single national entity to be the steward for healthcare performance measurement and quality improvement.
12 The NATIONAL QUALITY FORUM (NQF)
13 NQF-ENDORSED CONSENSUS STANDARDS
14 NQF Consensus Development Process Conceptualize and Plan Project Appoint Steering Committee and Technical Advisory Panels Identify (open call) and Evaluate measures, etc.; Propose candidate voluntary consensus standard (VCS) Review and Revise Board of Directors, NQF Staff & Management Member Councils, Non-member External Entities NQF ( nominations from membership and public) Steering Committee with NQF Staff (any entity can propose measures, etc., for consideration Member Councils, Member Organizations, Public Vote by Member Councils Member Organizations Approved by All Member Councils Review and Revision of unapproved VCS Member Councils, Member Organizations, Public Repeat Vote Approved by at least 2 Councils Approved by 0 or 1 Council (no further action) Board of Directors Vote Appeals of Board-endorsed VCS NQF-Endorsed Voluntary Consensus Standard Board of Directors Members and Nonmembers directly and materially affected by VCS
15 NQF National Consensus Standards: Patient Safety Patient Safety Strategic Priorities (2001) Serious Reportable Adverse Events (2002) Safe Practices (2003) Standardized Patient Safety Taxonomy (2005) Improved Medication Use Recommendations (2005) Improved Informed Consent Process (2005)
16 NQF National Consensus Standards: Institutions/Settings of Care Acute Care Hospital National Performance Measures Initial Set (2003) Nursing Care PMs (2004) Cardiac Surgery PMs (2004) Coordination of Care PMs (2005) Mortality for AMI, CHF and CAP (2005) HCAPHS (2005)
17 NQF National Consensus Standards: Institutions/Settings of Care Nursing Home Care Performance Measures (2002, 2004) Home Care PMs (2005) Palliative and Hospice Care Framework (2005) Ambulatory Care ( ) Dialysis Centers/ESRD (2006)
18 NQF National Consensus Standards: Conditions/Populations Diabetes (2002, 2005) Cancer Care Quality Measures ( ) Deep Venous Thrombosis ( ) Child Healthcare PMs (?2006) Behavioral Healthcare PMs ( )
19 NQF National Consensus Projects National Priorities for Healthcare Quality Measurement and Reporting 15 Healthcare conditions priorities 5 Process of care priorities 2 Infrastructure priorities
20 NATIONAL CONSENSUS STANDARDS FOR AMBULATORY CARE
21 NQF National Consensus Standards: Ambulatory Care Project Phase I (2004) Identify priority areas Phase II (2005) Expedited consensus of existing ambulatory care PMs Phase III ( ) Flesh out all 12 priority areas; four cycles
22 National Consensus Standards for Ambulatory Care: Phase I - Priority Areas Patient experience with care Coordination of care Asthma Prevention, including immunization Medication management Ischemic heart disease Diabetes Hypertension Depression Obesity
23 National Consensus Standards for Ambulatory Care: Additional Priority Areas Prenatal care Bone conditions
24 National Consensus Standards for Ambulatory Care: Phase II 36 physician-focused PMs endorsed in seven priority areas (8/3/05) 6 measures will undergo a second round of voting 2 measures not endorsed will be reconsidered in Phase 3
25 NQF-Endorsed TM Ambulatory Care Consensus Standards Asthma/Respiratory Illness (4) Behavioral Health/Depression (3) Bone Conditions (2) Heart Disease CAD(10), CHF (7) Hypertension (2) Prenatal Care (2) Prevention, Immunization, and Screening (6)
26 NQF-Endorsed TM Ambulatory Care Consensus Standards Asthma/Respiratory Illness Asthma assessment Asthma: pharmacologic therapy Appropriate treatment for children with upper respiratory infection Appropriate testing for children with pharyngitis
27 NQF-Endorsed TM Ambulatory Care Consensus Standards Behavioral Health/Depression Optimal practitioner contacts for medication management Effective acute phase treatment Effective continuation phase treatment Bone Conditions Osteoarthritis: assessment for use of anti-inflammatory or analgesic overthe-counter medications Osteoarthritis: functional and pain assessment
28 NQF-Endorsed TM Ambulatory Care Consensus Standards Heart Disease Coronary artery disease Symptoms and activity Cholesterol screen Lipid profile Drug therapy for lowering low-density lipoprotein (LDL) cholesterol Cholesterol control LDL cholesterol level Anti-platelet therapy Beta blocker therapy prior myocardial infarction ACEI/ARB therapy Smoking cessation and smoking cessation intervention
29 NQF-Endorsed TM Ambulatory Care Consensus Standards Heart Disease Congestive heart failure Left ventricular function (LVF) assessment Weight measurement Assessment of clinical symptoms of volume overload Assessment of activity level Beta blocker therapy ACEI/ARB therapy Warfarin therapy for patients with atrial fibrillation
30 NQF-Endorsed TM Ambulatory Care Consensus Standards Hypertension Plan of care Controlling high blood pressure Prenatal Care Anti D immune globulin Screening for human immunodeficiency virus (HIV)
31 NQF-Endorsed TM Ambulatory Care Consensus Standards Prevention, Immunization, and Screening Tobacco use and tobacco cessation Advising smokers to quit, discussing smoking cessation medication, and discussing smoking cessation strategies Discussing urinary incontinence and receiving urinary incontinence treatment Flu shot for older adults and flu shot for adults ages years Influenza vaccination Pneumonia vaccination
32 Phase II Measures in 2 nd Round of Voting Use of appropriate medications for people with asthma Coronary artery disease: Beta-blocker treatment after a heart attack Childhood immunization Breast cancer screening Colorectal cancer screening Cervical cancer screening
33 National Consensus Standards for Ambulatory Care: Phase III Cycle 1 (Fall 2005): care coordination, medication management, obesity, asthma, hypertension, prevention Cycle 2 (Spring 2006): patient experience with care, heart disease, bone conditions, prenatal care, behavioral health, diabetes
34 National Consensus Standards for Ambulatory Care: Phase III Cycle 3 ( ): special ambulatory settings of care (i.e., ambulatory surgical centers) Cycle 4 ( ): development of index/composite measures
35 National Consensus Standards for Ambulatory Care: Project Deliverables Sets of endorsed consensus standards Recommendations for implementation and research issues for each set. Commissioned background paper on barriers to small group (< 5), provider-level implementation Index(es)/composite(s) for ambulatory care measurement and reporting. Workshop to guide ambulatory care measurement research, development, and testing
NQF Measure Number & PQRI Implementation Number
Title NQF Steward s Adult Weight Screening and Follow-Up Hypertension: Blood Pressure ment Preventive Care and Screening Pair: a. Tobacco Use Assessment, b. Tobacco Cessation Intervention with a calculated
Component 2: The Culture of Health Care. Overview. Definitions and operationalization
Component 2: The Culture of Health Care Unit 7: Quality Measurement, Performance Improvement, and Incentive Payment Schemes Lecture 2 This material was developed by Oregon Health & Science University,
Meaningful Use Clinical Quality Measures for Eligible Professionals
Meaningful Use Clinical Quality Measures for Eligible Professionals Measure Type NQF ID CMS ID Description Title: Adult Weight Screening and Follow-Up 1 NQF 0421 PQRI 128 calculated BMI in the past six
Clinical Quality Measures for Submission by Medicare or Medicaid EP/s for the 2011 and 2012 Payment Year
1 NQF 0059 1 NQF 0064 2 NQF 0061 3 Title: Diabetes: Hemoglobin A1c Poor Control Description: Percentage of patients 18-75 years of age with diabetes (type 1 or type 2) who had hemoglobin A1c > 9.0%. Title:
Clinical Quality Measures
Core Measures Preventive Care and Screening Measure Pair: a. Tobacco Use Assessment, b. Tobacco Cessation Intervention. Percentage of patients aged 18 years and older who have been seen for at least 2
HEALTHCARE REFORM. September 2012
HEALTHCARE REFORM Accountable Care Organizations: ACOs 101 September 2012 The enclosed slides are intended to provide you with a general overview of accountable care organizations (ACOs), created within
For Electronic Measure Specification Information go to:
Diabetes Recognition NQF 0421 PQRI 128 Title: Adult Weight Screening and Follow-Up Description: Percentage of patients aged 18 years and older with a calculated BMI in the past six months or during the
Table 1. Proposed Measures for Use in Establishing Quality Performance Standards that ACOs Must Meet for Shared Savings
CMS-1345-P 174 Table 1. Proposed Measures for Use in Establishing Quality Performance Standards that ACOs Must Meet for Shared Savings AIM: Better Care for Individuals 1. Patient/Care Giver Experience
CLINICAL QUALITY MEASURES Stage 1 Meaningful Use
CLINICAL QUALITY MEASURES Stage 1 Meaningful Use * Eligible professionals (EPs) must report on 3 required core clinical quality measures (CQMs). If the denominator of 1 or more of the required core measures
proposed set to a required subset of 3 to 5 measures based on the availability of electronic
CMS-0033-P 143 proposed set to a required subset of 3 to 5 measures based on the availability of electronic measure specifications and comments received. We propose to require for 2011 and 2012 that EP's
2016 General Practice/Family Practice Preferred Specialty Measure Set
1 0059 5 0081 41 N/A 50 N/A 65 0069, EHR 66 0002, EHR Effective Clinical Care Effective Clinical Care Effective Clinical Care Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%): Percentage of patients
Measurement Name Beta-Blocker Therapy Prior Myocardial Infarction (MI)
Program Metrics The list below includes the metrics that will be calculated by the PINNACLE Registry for the outpatient office setting. These include metrics for Artery, Atrial Fibrillation, Hypertension
The Role of Health Information Technology in Implementing Disease Management Programs
The Role of Health Information Technology in Implementing Disease Management Programs Donald F. Wilson, MD Medical Director Quality Insights of Pennsylvania May 11, 2006 Statewide Combined Topic Average
Overview of Current Quality Measures that can be Impacted by Ambulatory Pharmacists
Overview of Current Quality Measures that can be Impacted by Ambulatory Pharmacists Measure Name Measure Domain Measure Focus Comment/Explanation CMS Value-based Purchasing Program (CMS VBP) AMI 30-day
Reduce Costs, Prevent Disease, Improve Employee Health
Reduce Costs, Prevent Disease, Improve Employee Health Using Proven Policies and Programs for Effective Change Texas Department of State Health Services Cardiovascular Health and Wellness Program From
Meaningful Use Simple Guide
Meaningful Use Simple Guide 2011-2012 CORE Measures 1. CPOE for Medication Orders 2. Drug Interaction Checks * 3. Maintain Problem & Diagnosis List 4. eprescribing (erx) escripts 5. Active Medication List
Meaningful Use Overview
Eligibility Providers may be eligible for incentives from either Medicare or Medicaid, but not both. In addition, providers may not be hospital based. Medicare: A Medicare Eligible Professional (EP) is
MEASURING CARE QUALITY
MEASURING CARE QUALITY Region December 2013 For Clinical Effectiveness of Care Measures of Performance From: Healthcare Effectiveness Data and Information Set (HEDIS ) HEDIS is a set of standardized performance
Preventive Care: A National Profile on Use, Disparities, and Health Benefits
Eduardo Sanchez, MD, MPH Director, Institute for Health Policy University of Texas School of Public Health Chair, National Commission on Prevention Priorities Preventive Care: A National Profile on Use,
2014 Clinical Quality Measures: Changes for the Medicaid EHR Incentive Program. Tracy McDonald Medicaid EHR Incentive Program Coordinator
2014 Clinical Quality Measures: Changes for the Medicaid EHR Incentive Program Tracy McDonald Medicaid EHR Incentive Program Coordinator Agenda Why are Clinical Quality Measures important? Clinical Quality
NCQA Health Insurance Plan Ratings Methodology October 2014
NCQA Health Insurance Plan Ratings Methodology October 2014 REVISION CHART Date Published December 2013 April 2014 October 2014 Description Draft version Final version Updated measure list with 50% rule
2018 MIPS Reporting Family Medicine
2018 MIPS Reporting Family Medicine Quality Reporting Requirements: Report on 6 quality measures or a specialty measure set Include at least ONE outcome or high-priority measure Report on patients of All-Payers
2016 Internal Medicine Preferred Specialty Measure Set
1 0059 Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%): Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period 5 0081 Registry, EHR, 9 0105
th Street, NW Suite 1000 Washington, DC phone fax
TO: Interested Organizations FROM: Patrick Dahill, Assistant Vice President, Accreditation & Measures Policy DATE: May 15 2017 (Updated on October 18, 2017) RE: Measures for Accreditation Scoring in 2018
16 th Annual IHA Stakeholders Meeting Session 1A
16 th Annual IHA Stakeholders Meeting Session 1A September 19, 2017 Hilton Los Angeles Airport Thank you to our Platinum Sponsor: IHA & PBGH ACO Measurement & Benchmarking Initiative September 19, 2017
MU - Selection & Configuration of Measures
MU - Selection & Configuration of Measures Presenter: Christy Erickson October 14, 2011 Objectives Review the 15 Core Measures and highlight some findings from the field Discuss the MU Menu and Clinical
th Street, NW Suite 1000 Washington, DC phone fax
TO: Interested Organizations FROM: Patrick Dahill, Assistant Vice President, Accreditation & Measures Policy DATE: September 19, 2016 RE: Measures for Accreditation Scoring in 2017 This communication gives
Disclosure. From the London Times... What Is Meaningful Use? 11/7/2011. Overview. The Road to Meaningful Use and Beyond
Disclosure The Road to and Beyond A Simple Overview of a Complex Topic I have no relevant financial relationships to disclose. HIT Subcommittee Dr. Charles King II, Chair Dr. Robert Warren Itara Barnes,
Measure Owner Designation. AMA-PCPI is the measure owner. NCQA is the measure owner. QIP/CMS is the measure owner. AMA-NCQA is the measure owner
2011 EHR Measure Specifications The specifications listed in this document have been updated to reflect clinical practice guidelines and applicable health informatics standards that are the most current
Achieving Quality and Value in Chronic Care Management
The Burden of Chronic Disease One of the greatest burdens on the US healthcare system is the rapidly growing rate of chronic disease. These statistics illustrate the scope of the problem: Nearly half of
Improving Quality of Care for Medicare Patients: Accountable Care Organizations
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 Office of Media Affairs MEDICARE FACT SHEET FOR IMMEDIATE RELEASE
Prescribe appropriate immunizations for. Prescribe childhood immunization as per. Prescribe influenza vaccinations in high-risk
Supplemental Digital Appendix 1 46 Health Care Problems and the Corresponding 59 Practice Indicators Expected of All Physicians Entering or in Practice Infectious and parasitic diseases Avoidable complications/death
Consensus Core Set: ACO and PCMH / Primary Care Measures Version 1.0
Consensus Core Set: ACO and PCMH / Primary Care s 0018 Controlling High Blood Pressure patients 18 to 85 years of age who had a diagnosis of hypertension (HTN) and whose blood pressure (BP) was adequately
HEDIS 2014 MQIC MEASURES SUMMARY LISTING FOR ANNUAL PERFORMANCE REPORTING
HEDIS 2014 MQIC MEASURES SUMMARY LISTING FOR ANNUAL PERFORMANCE REPORTING DIABETES 1. Comprehensive Diabetes Care (CDC): Percentage of members 18-75 years of age with diabetes (type 1 and type 2) who had
Advances in Alignment, Measurement, and Performance MY 2017 Results Highlights
Advances in Alignment, Measurement, and Performance MY 2017 Results Highlights Align. Measure. Perform. (AMP) Programs Launched in 2003, VBP4P is a statewide performance improvement program and one of
Meaningful Use for Eligible Providers
Meaningful Use for Eligible Providers Summary of Core and Menu objectives and Clinical Quality s Healthcare Technical Assistance Program, March 11, 2011 V.1.0Copyright 2011, Purdue Research Foundation
Certified Health IT Transparency and Disclosure Information 2014 Edition
Certified Health IT Transparency and Disclosure Information 2014 Edition 2015 Edition Certified Health IT Transparency and Disclosure Information I. Disclaimer This Complete EHR is 2014 Edition compliant
Quality Payment Program: Cardiology Specialty Measure Set
Measure Title * Reportable via PINNACLE α Reportable via Diabetes Collaborative CQMC v1.0 Measure High Priority Measure Cross Cutting Measure Heart Failure (HF): Angiotensin- Converting Enzyme (ACE) Inhibitor
Performance Measures for Adult Immunization
Performance Measures for Adult Immunization Reva Winkler, MD, MPH Senior Director, Performance Measures May 15, 2012 1 NQF-endorsed consensus standards for adult immunizations Influenza immunization 0431
Consensus Core Set: Cardiovascular Measures Version 1.0
Consensus Core Set: Cardiovascular s NQF 0330 Hospital 30-day, all-cause, riskstandardized readmission rate (RSRR) following heart failure hospitalization 0229 Hospital 30-day, all-cause, riskstandardized
HEDIS/CAHPS 101 August 13, 2012 Minnesota Measurement and Reporting Workgroup
HEDIS/CAHPS 101 Minnesota Measurement and Reporting Workgroup MNsure s Accessibility & Equal Opportunity (AEO) office can provide this information in accessible formats for individuals with disabilities.
THE NATIONAL QUALITY FORUM
National Voluntary Consensus Standards for Patient Outcomes Summary of the Diabetes/Metabolic Technical Advisory Panel Conference Call December 15, 2009: 2:00-3:30 pm Eastern Standard Time TAP Members
Reimbursement in the Pay for Performance Era. Jeffrey Bush Director, Corporate Reimbursement Becton, Dickinson and Company (BD)
Reimbursement in the Pay for Performance Era Jeffrey Bush Director, Corporate Reimbursement Becton, Dickinson and Company (BD) AGENDA Alphabet Soup Pay For Performance (P4P) CMS Hospital Quality Initiative
Program Metrics. New Unique ID. Old Unique ID. Metric Set Metric Name Description. Old Metric Name
Program Metrics The list below includes the metrics that will be calculated by the PINNACLE Registry for the outpatient office setting. These include metrics for, Atrial Fibrillation, Hypertension and.
Provider Perspective of Quality Measurement
Provider Perspective of Quality Measurement The American Medical Group Association supports its members in enhancing population health and care for patients through integrated systems of care Improve
Meaningful Use Criteria for Pediatric Providers
SET OF CRITERIA - 15 REQUIRED These 15 core criteria are called the core set and are required elements for demonstrating meaningful use. This document was prepared for pediatric providers so language pertaining
MEASURING CARE QUALITY
MEASURING CARE QUALITY Region November 2016 For Clinical Effectiveness of Care Measures of Performance From: Healthcare Effectiveness Data and Information Set (HEDIS ) HEDIS is a set of standardized performance
Opportunities for Developing Measures for Adult Vaccines
Opportunities for Developing s for Adult Vaccines May 15, 2012 National Adult Immunization Summit Tilithia McBride Avalere Health LLC Why s? VA Program Demonstrates Success of ment to Improve Vaccination
NEW JERSEY 2012 HOSPITAL PERFORMANCE REPORT TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES
NEW JERSEY 2012 HOSPITAL PERFORMANCE REPORT TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES New Jersey Department of Health Health Care Quality Assessment June 2013 NEW JERSEY
NEW JERSEY 2011 HOSPITAL PERFORMANCE REPORT TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES
NEW JERSEY 2011 HOSPITAL PERFORMANCE REPORT TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES New Jersey Department of Health and Senior Services Health Care Quality Assessment
Modified Stage 2 Meaningful Use: Clinical Quality Measures (CQMs) Massachusetts Medicaid EHR Incentive Payment Program
Modified Stage 2 Meaningful Use: Clinical Quality Measures (CQMs) Massachusetts Medicaid EHR Incentive Payment Program July 21, 2016 Today s presenter: Al Wroblewski, PCMH CCE, Client Services Relationship
Quality Reporting for CAHs and Rural PPS Hospitals: The Potential Impact of Composite Measures
UpperMidwest Rural Health Research Center www.uppermidwestrhrc.org July 202 Policy Brief Quality Reporting for CAHs and Rural PPS Hospitals: The Potential Impact of Composite Measures Michelle Casey MS,
QIOs: Partners for Quality Improvement Under the Medicare Drug Benefit
QIOs: Partners for Quality Improvement Under the Medicare Drug Benefit Presentation to The 2 nd Annual National Medicare Prescription Drug Congress David Schulke Executive Vice President The American Health
Cardiovascular Health Practice Guideline Outpatient Management of Coronary Artery Disease 2003
Authorized By: Medical Management Guideline Committee Approval Date: 12/13/01 Revision Date: 12/11/03 Beta-Blockers Nitrates Calcium Channel Blockers MEDICATIONS Indicated in post-mi, unstable angina,
QUALITY IMPROVEMENT Section 9
Quality Improvement Program The Plan s Quality Improvement Program serves to improve the health of its members through emphasis on health maintenance, education, diagnostic testing and treatment. The Quality
2016 Physician Quality Reporting System (PQRS) GPRO Web Interface Measures List 12/18/2015
2016 Physician Quality Reporting System (PQRS) Web Interface 12/18/2015 NQF, ) Care Coordination/Patient Safety (CARE) s (2 s Individually Sampled) CARE-2 Falls: Screening for Future Fall Risk Only #318
ISCHEMIC VASCULAR DISEASE (IVD) MEASURES GROUP OVERVIEW
ISCHEMIC VASCULAR DISEASE (IVD) MEASURES GROUP OVERVIEW 2014 PQRS OPTIONS F MEASURES GROUPS: 2014 PQRS MEASURES IN ISCHEMIC VASCULAR DISEASE (IVD) MEASURES GROUP: #204. Ischemic Vascular Disease (IVD):
In Pursuit of Excellence: The CheckPoint Journey
Focus On Quality... In Pursuit of Excellence: The CheckPoint Journey Charles Shabino, MD; Dana Richardson, RN, MHA Abstract In March 2004, the Wisconsin Hospital Association launched CheckPoint sm (www.wicheckpoint.org)
HEDIS 2017 MQIC MEASURES SUMMARY LISTING FOR ANNUAL PERFORMANCE REPORTING
HEDIS 2017 MQIC MEASURES SUMMARY LISTING FOR ANNUAL PERFORMANCE REPORTING ATTENTION-DEFICIT/HYPERACTIVITY DISORDER 1. Follow-up Care for Children Prescribed ADHD Medication (ADD) Percent children newly
Quality Payment Program: Cardiology Specialty Measure Set
Quality Payment Program: Cardiology Specialty Set Title Number CMS Reporting Method(s) Heart Failure (HF): Angiotensin- Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for
Optimal Asthma Control Data Specifications
Optimal Asthma Control Data Specifications Final Version December 2009: Updated for Population Identification April 2010 MNCM Measure Description Methodology Rationale Composite measure of the percentage
Physician Consortium for Performance Improvement (PCPI) Performance Measure Status Report
Acute Otitis Externa / Otitis Media with Effusion (8 measures) (AAO-HNS Foundation) AOE : Topical therapy AOE : Pain assessment AOE : Systemic antimicrobial therapy avoidance of inappropriate use OME :
Comprehensive ESRD Care (CEC) Model Proposed Quality Measures for Public Comment. Table of Contents
Comprehensive ESRD Care (CEC) Model Proposed Quality s for Public Comment Table of Contents Page # Introduction 3 Summaries by Domain Technical Expert Panel Recommended CEC Quality s 4 s that were recommended
AMI Talking Points. Provide appropriate treatment to Acute MI patients with these core measures:
AMI Provide appropriate treatment to Acute MI patients with these core measures: Aspirin received within 24 hours of arrival or contraindication documented Primary PCI Received Within 90 Minutes of Hospital
Practice-Level Executive Summary Report
PINNACLE Registry Metrics 0003, Test Practice_NextGen [Rolling: 1st April 2015 to 31st March 2016 ] Generated on 5/11/2016 11:37:35 AM American College of Cardiology Foundation National Cardiovascular
Disclosures. May 15 th, Influenza Vaccination as Secondary Prevention for Acute Coronary Events Where do we need to go in clinical practice?
Influenza Vaccination as Secondary Prevention for Acute Coronary Events Where do we need to go in clinical practice? May 15 th, 2014 Robi Goswami, MD Cardiologist Piedmont Heart Institute Disclosures None
2017 Physician Incentive Program by Payer
2017 Physician Incentive Program by Payer BCN Commercial Payout Summary TARGET AMOUNT per SERVICE Breast screening 80%+ $125^ Childhood immunizations ( % of who children who turn 2 in Flat fee $50 the
2012 Core Measures. Acute Myocardial Infarction (AMI)
2012 Core Measures Acute Myocardial Infarction (AMI) Aspirin at Arrival Aspirin Prescribed at Discharge Angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) for left ventricular
The CSAC will review recommendations from the Cardiovascular 2015 project during its January 12, 2016 conference call.
TO: FR: RE: Consensus Standards Approval Committee (CSAC) Melissa Marinelarena, Leslie Vicale, Donna Herring Cardiovascular 2015 Member Voting Results DA: January 12, 2016 The CSAC will review recommendations
AMCP Webinar Series. Exchanges and Qualified Health Plans: How your voice can shape the future of quality reporting 14 January 2014.
AMCP Webinar Series Exchanges and Qualified Health Plans: How your voice can shape the future of quality reporting 14 January 2014 Speaker Mitzi Wasik, Pharm.D., BCPS Director, Pharmacy Medicare Programs
Performance and Quality Measures 1. NQF Measure Number. Coronary Artery Disease Measure Set
Unless indicated, the PINNACLE Registry measures are endorsed by the American College of Cardiology Foundation and the American Heart Association and may be used for purposes of health care insurance payer
PROGRAM ASSISTANCE LETTER
PROGRAM ASSISTANCE LETTER DOCUMENT NUMBER: 2015-01 DATE: November 25, 2014 DOCUMENT TITLE: Proposed Uniform Data System Changes for Calendar Year 2015 TO: Health Centers Primary Care Associations Primary
ACO Name and Location. ACO Primary Contact. Michele Muldoon. Organizational Information. Primary Contact Name
ACO Name and Location Healthy Communities ACO, LLC 255 Lafayette Ave. Suffern, New York 10901 ACO Primary Contact Primary Contact Name Michele Muldoon Primary Contact Phone Number (845) 368-5083 Primary
HEDIS 2015 MQIC MEASURES SUMMARY LISTING FOR ANNUAL PERFORMANCE REPORTING
HEDIS 2015 MQIC MEASURES SUMMARY LISTING FOR ANNUAL PERFORMANCE REPORTING DIABETES 1. Comprehensive Diabetes Care (CDC): Percentage of members 18-75 years of age with diabetes (type 1 and type 2) who had
New PINNACLE Measures The below measures for PINNACLE will be added as new measures to the outcomes reporting starting with Version 2.0.
New PINNACLE Measures The below measures for PINNACLE will be added as new measures to the outcomes reporting starting with Version 2.0. Measure Steward Measure Name Measure Description Rationale for Adding
Minimal Essential Coverage Healthcare2U Direct Primary Care Benefits Proposal
Minimal Essential Coverage Healthcare2U Direct Primary Care Benefits Proposal Presented By: About Staff Benefits Management & Administrators What We Do: SBMA provides comprehensive benefits administration
Manitoba Primary Care Quality Indicators Full Guide Version 3.0 Quick Reference Summary
PREVENTION 2.01 Cervical Cancer 2.02 Colon Cancer 2.03 Breast Cancer 2.04 Dyslipidemia for Women 2.05 Dyslipidemia for Men Female 21-69 PAP 36 Percentage of female enrolled patients 21 to 69 years of age
Measuring and Improving Quality in Accountable Care Organizations
Measuring and Improving Quality in Accountable Care Organizations Joachim Roski, PhD MPH Fellow, Economic Studies Managing Director, High Value Healthcare Initiative Overview ACOs and health care reform
ACO Name and Location. ACO Primary Contact. Organizational Information. Scott Berkowitz, MD, MBA
ACO Name and Location Medicine Alliance for Patients, LLC 6704 Curtis Court Glen Burnie, Maryland 21060 ACO Primary Contact Primary Contact Name Primary Contact Phone Number 443-287-4519 Scott Berkowitz,
Measure Owner Designation. AMA-PCPI/NCQA (contract) is the measure owner. AMA-PCPI is the measure owner. AMA-PCPI/ASCO/NCCN is the measure owner
2012 EHR Measure Specifications The specifications listed in this document have been updated to reflect clinical practice guidelines and applicable health informatics standards that are the most current
Meaningful Use & Million Hearts. Improving Cardiovascular Disease & Stroke Through Quality Measurements
Meaningful Use & Million Hearts Improving Cardiovascular Disease & Stroke Through Quality Measurements Phone lines are now muted Find this or any previous webinar, go to http://www.ehrhelp.missouri.edu
Nancy Merriman, Executive Director Alaska Primary Care Association
Nancy Merriman, Executive Director Alaska Primary Care Association nancy@alaskapa.org 907-929-2725 1. Must serve a high needs area (designated Medically Underserved Area or Population) 2. Comprehensive
HEART FAILURE QUALITY IMPROVEMENT. American Heart Association Shawni Smith Regional Director, Quality & Systems Improvement
HEART FAILURE QUALITY IMPROVEMENT American Heart Association Shawni Smith Regional Director, Quality & Systems Improvement 1 DISCLOSURES NONE 2 3 WHY IS THIS IMPORTANT? WHY? Heart Failure Currently, an
convey the clinical quality measure's title, number, owner/developer and contact
CMS-0033-P 153 convey the clinical quality measure's title, number, owner/developer and contact information, and a link to existing electronic specifications where applicable. TABLE 20: Proposed Clinical
2015 PQRS Registry. Source Measure Title Measure Description CITIUS1
1 CQ-IQ covers 65 CMS defined measures that Eligible Providers (EPs) have to report on to assess quality of care provided to the patients. Version Supported: PQRS Registry 2015 65 measures Reporting Period:
Primary and Secondary Prevention of Cardiovascular Disease. Frank J. Green, M.D., F.A.C.C. St. Vincent Medical Group
Primary and Secondary Prevention of Cardiovascular Disease Frank J. Green, M.D., F.A.C.C. St. Vincent Medical Group AHA Diet and Lifestyle Recommendations Balance calorie intake and physical activity to
Promoting Clinical Preventive Services for Older Adults:
Promoting Clinical Preventive Services for Older Adults: Key Opportunities for the Aging Network Maggie Moore, MPH CDC Healthy Aging Program 26 th National Home and Community Based Services Conference
ACO Public Reporting
ACO Public Reporting ACO Name and Location AHS ACO LLC (Atlantic Accountable Care Organization) 465 South Street, Suite 205 Morristown, NJ 07960 (973) 971-7499 atlanticaco@atlantichealth.org www.atlanticaco.org
Under the Affordable Care Act (ACA), private insurers except for plans that have been
Brought to you by the insurance professionals at HUB International Preventive Care Once an underused component of the health care world that benefits both employees health and employers health care spending,
ACO Name and Location. ACO Primary Contact. Organizational Information
ACO Name and Location Pinehurst Accountable Care Network, Inc. 5 First Village Drive Pinehurst, North Carolina 28374 ACO Primary Contact Primary Contact Name Jim Faircloth Primary Contact Phone Number
ACO Name and Location. ACO Primary Contact. Organizational Information
ACO ame and Location Ascension Care Management Health Partners Evansville, LLC Previous Legal Business Entity ame: MissionPoint Evansville, LLC 523 Mainstream Dr ashville, Tennessee 37228-1238 ACO Primary
ACO Name and Location. ACO Primary Contact. Organizational Information N N N N N N
ACO ame and Location CHI Continuum LLC dba CaroMont ACO 2525 Court Drive Gastonia, orth Carolina 28054 ACO Primary Contact Primary Contact ame Betty J. Herbert Primary Contact Phone umber 704-834-4532
Preferred Care Partners. HEDIS Technical Standards
Preferred Care Partners HEDIS Technical Standards 1 HEDIS What is HEDIS HEDIS Overview Adults HEDIS Overview Pediatrics HEDIS is a registered trademark of the National Committee for Quality Assurance 2
Jan Feb Mar Apr May Jun Jul Aug Sep X X X X X X X. Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov X X X X X X X X X X X X X
Primary Prevention Breast Cancer Prevention Member: Mammography reminder letters to female members ages 51.5-74 who are overdue to get a mammogram Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Providers:
SCORES FOR 4 TH QUARTER, RD QUARTER, 2014
SCORES FOR 4 TH QUARTER, 2013 3 RD QUARTER, 2014 PATIENT SATISFACTION SCORES (HCAHPS): 4 STARS OUT OF 5 (ONLY 4 AREA ACUTE CARE HOSPITALS RECEIVED A 4-STAR RATING. NONE ACHIEVED 5-STARS). STRUCTURAL MEASURES:
Appendix G Explanation/Clarification Summary
Appendix G Explanation/Clarification Summary Summary of Changes for Recommendations Alignment of measures with VBP by fiscal year Measures and service dates were adjusted to be consistent with the FY2016
UCLA Health System Apr - Jun 2013 (Q2)
Denom Observed VBP Standard VBP Benchmark Denom Observed VBP Standard VBP Benchmark N Percent x/n N Percent x/n Value Based Purchasing-Clinical Process of Care Measures (%) SCIP-Inf-9 Urinary catheter
Preventive Health Guidelines
Preventive Health Guidelines Guide to Clinical Preventive Services Adult LifeWise has adopted the United States Preventive Services Task Force (USPSTF) Guide to Clinical Preventive Services. The guideline
Patient-Centered Primary Care Scorecard Measures
Patient-Centered Primary Care Scorecard Measures Acute and Chronic Care Management Measures Medication Adherence Proportion of Days Covered (PDC): Oral Diabetes Identifies patients with at least two prescriptions
Summary of Research and Writing Activities In Cardiovascular Disease
Summary of Research and Writing Activities In Cardiovascular Disease Carole Alison Chrvala, PhD 919.545.2149 (Work) 919.951.5230 (Mobile) cchrvala@centurylink.net www.healthmattersmedwriting.com 1 Manuscripts