Aligning Quality Measure Sets – Successful Use
of Online Measure Selection Tool with 2015
Updates
Gerry Shea, Michael Bailit, Christine Hughes, and Susan Schow
February 24, 2015
Welcome and Introduction
Gerry Shea
Buying Value Project Director
[email protected]
202 256-7577
www.buyingvalue.org
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Asking Questions
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ask questions.
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The Buying Value Project
Buying Value is an RWJF-funded initiative of private health care purchasers—
employers, leading business health organizations, and union health funds – that was
launched in 2012.
 Mission – Private purchasers contribute to better health and lower health
costs by buying on value rather than on volume.
 Objective – Enable widespread adoption of value purchasing in the private
sector through alignment of measures among private purchasers and with
federal and state public programs
 Strategy
Measure Alignment Campaign – Public and private purchasers, health
plans, providers, and care delivery systems commit to core measure sets
developed through multi-stakeholder consensus processes nationally, and
at the regional or state level.
Help for States/Other Stakeholders in Creating Aligned Measure Sets –
Online Measure Selection Tool and hands-on help.
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Buying Value Milestones
• Website www.buyingvalue.org (2012) -- Basic info on valuepurchasing – Primer, Legal Memo on Anti-Trust Issues
• “Starter” Core Measure Set (March 2013) – National
purchasers, consumers, CMS & payers (health plans)
• Study of 48 Measure Sets in Use at State Level (2013) -- Only
20% of measures used by more than one program; 25% of shared
measures modified in some way; 39% of measures either non-standard
or homegrown
• Model for Consensus Core Measure Sets -- A multi-stakeholder,
two-tier (national and regional or state) process for consensus core measure sets
• Online Measure Selection Tool (9/2014; Updated 1/2015) –
web-based spreadsheet linked to measure databases that enables those creating
measure sets to view in one place a multitude of important decision factors.
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The State of (Mis)Alignment
2013 Buying Value study of state quality
measure sets:
 Only 20% of measures used by more than one
program
 23% of shared measures modified in some way
 39% of measures non-standardized or
“homegrown”
The result? Tremendous variation in the way we define
and evaluate “quality” across the country.
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Measure Alignment Work: Federal Agencies To
Cut 94% of Measures in Seven Key Areas!
Number of Measures Reviewed
76
Obesity
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86
Perinatal
5
138
HIV/AIDS
Topic Area
Number of Measures in Harmonized Measure Set
7
105
Hospital Acquired Conditions
9
48
Depression
3
63
Smoking Cessation
4
51
Hypertension
2
0
20
40
60
80
100
120
7
140
160
Other Measure Alignment Work
• CMMI State Innovation Model (SIM) Grants
– 38 states & $1 billion in federal funds to develop & test innovative
payment and service delivery models in public programs for use in
statewide multi-payer programs with aligned measure sets.
• IOM Committee on Core Metrics for Better
Health at Lower Costs
– Report originally due in fall, 2014
– Now expected late February
• Commercial Measures Alignment Project
– AHIP initiative, staffed by NQF, to align measures with CMS
– Report originally expected in fall, 2014
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Presenters
Michael Bailit
President
Bailit Health
[email protected]
Christine Hughes
Senior Consultant
Bailit Health
[email protected]
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How to Build a Measure Set
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2015 Buying Value Measure Set Updates
• Updates to the following federal measure sets:
January 2015:
– Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP
(Child Core Set)
– Core Set of Health Care Quality Measures for Adults Enrolled in Medicaid
(Medicaid Adult Core Set)
– Physician Quality Reporting System (PQRS) for 2015 (entire list)
• EP EHR Incentive Clinical Quality Measures (eCQMs)(for 2015)
• Cross-cutting Measures
November 2014:
– CMS Medicare Shared Savings Program (MSSP) ACO for 2015
– CMS Medicare Part C & D Star Ratings Measures
• Addition of multi-stakeholder aligned measure sets from Maine and
Washington
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Demonstration of the Measure Selection Tool
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Selected Organizations That Have Used the
Measure Select Tool
• Maine Health Management Coalition
• Vermont Green Mountain Care Board
• Washington Health Alliance
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Experience with the Buying Value Measure
Selection Tool
• Susan Schow, Maine Health Management Coalition
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Use of the Buying Value Tool in Maine
Susan Schow, MPH, Healthcare Measurement Analyst
MHMC’s Measure Alignment Efforts
Accountable Care Implementation Committee’s Work
Group Established
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Align measures used for Accountable Care Organization (ACO)
payment and contracting
Develop multi-payer measure set aligned closely with CMS ACO
measures supplemented with pediatric and women’s health metrics
To minimize reporting burden, initial phase will rely on claims-based
measures and available uniform survey results
Identify outcomes measures for adoption as reporting capabilities
grow
Establish protocol for identification of “pending” measures (outcomes,
functional status, etc.)
Maine Health Management Coalition | Maine Health Management Coalition-Foundation
11 Bowdoin Mill Island, Suite 260 | Topsham, ME 04086 | (207) 899-1971 | www.mehmc.org | www.getbettermaine.org
Maine’s Measure Alignment WG
Identified Ten Criteria for Measure Inclusion:
• Current Feasibility
• Evidence-based and Scientifically Acceptable
• Setting Free
• Usability / Adaptability
• Patient Experience
• Has a Relevant Benchmark
• Financial / Incentivization
• Improving this Measure will Translate into Significant Changes
in Value
• Durability
• Aligned with Other Measure Sets
Maine Health Management Coalition | Maine Health Management Coalition-Foundation
11 Bowdoin Mill Island, Suite 260 | Topsham, ME 04086 | (207) 899-1971 | www.mehmc.org | www.getbettermaine.org
Maine’s Measure Alignment WG
How to evaluate or score each measure with so many
different criteria?
• Buying Value Tool allowed scoring each measure as to how
well it meets each criteria:
• Yes = 2 points
• Somewhat = 1 point
• No = 0 points
• Summed points for each measure
• Used tally to guide final review of draft measures for inclusion
• Allows for adding comments to record decisions
• Made complex task easy and documentable
Maine Health Management Coalition | Maine Health Management Coalition-Foundation
11 Bowdoin Mill Island, Suite 260 | Topsham, ME 04086 | (207) 899-1971 | www.mehmc.org | www.getbettermaine.org
Maine’s Measure Alignment WG
Aligning with Other Measure Sets
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To shorten the list being considered, needed to identify measures most
commonly used
Many measures are similar but slightly different (e.g., Optimal Diabetes
Care and Comprehensive Diabetes Care)
Tool includes multiple federal measure set lists
Allows inclusion of relevant local commercial and state measure sets
Tool counts the highest overlap of reporting for identifying opportunities for
alignment
Maine Health Management Coalition | Maine Health Management Coalition-Foundation
11 Bowdoin Mill Island, Suite 260 | Topsham, ME 04086 | (207) 899-1971 | www.mehmc.org | www.getbettermaine.org
Q&A
• Roll over the green bar at the top of the page and left click on Q&A
or Chat.
• Type your question in the box.
• Click on “All Panelists” in the
“Ask” box.
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For More Information and a Helpful Resource
• Buying Value
 www.BuyingValue.org
• Bailit-authored brief titled “Considerations for
State Development of Performance Measure Sets”
 www.rwjf.org/en/research-publications/find-rwjfresearch/2014/09/considerations-for-statedevelopment-of-performance-measure-sets.html
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