Performance Measurement Accelerating Improvement (2006) / Chapter Skim
Currently Skimming:
2 Current and Future State of Performance Measurement and Reporting
2 Current and Future State of Performance Measurement and Reporting
Pages 40-62
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 40... ...
In recent years, improving health care quality has become a top priority for all major stakeholders in the health care system -- the federal government, group purchasers, health care professionals, health care providers, state governments, oversight organizations, consumer groups, and others. Hundreds of efforts now under way, including public reporting, pay-forperformance, and ongoing quality improvement programs, are aimed at enhancing quality.
|
From page 41... ...
The development of multiple quality measures has been driven by stakeholders eager to see certain features of care recognized and rewarded as part of quality improvement initiatives. These efforts rely greatly upon consensual efforts and private support from key membership organizations.
|
From page 42... ...
PERFORMANCE MEASUREMENT AND REPORTING: WHAT DO WE MEAN? Quality-related efforts in all of the areas noted above -- public reporting, quality improvement initiatives, and pay for performance -- rely on some form of performance measurement and reporting.
|
From page 43... ...
The final section draws on this analysis and the work of other groups to define the key attributes of an effective national system, including 10 design principles the committee believes should guide the system's development. RECENT EFFORTS TO PROMOTE STANDARDIZED PERFORMANCE MEASUREMENT Efforts to standardize quality measurement and reporting in the health care system have been under way for more than 15 years.
|
From page 44... ...
. CMS now requires health plans participating in the Medicare program to submit data on HEDIS-developed measures of health care quality, many of which are incorporated in comparative quality reports available on the CMS Web site (CMS, 2005d)
|
From page 45... ...
In the late 1990s, JCAHO embarked on a second effort to implement performance measures as a condition of accreditation for hospitals, longterm care organizations, networks, home health agencies, and behavioral health care organizations. Health care organizations were allowed great discretion in selecting measures from a large menu, and the measure specifications were not standardized (JCAHO, 2005d)
|
From page 46... ...
Widespread Collaborative Efforts As the twenty-first century approached, the need to coordinate the national bodies involved in the promulgation of standardized performance measures became increasingly apparent. In addition to the efforts of the major national players, dozens of more narrowly focused or local efforts were aimed at establishing new standardized measure sets.
|
From page 47... ...
Publicly available performance information varied greatly in terms of availability by geographic area, participation of various types of providers, comprehensiveness and relevance of quality measures, validity and reliability of data, and usefulness of public reporting formats. Health care leaders recognized the need for a national infrastructure and process for setting goals and priorities for performance measurement and improvement, promulgating standardized measure sets for use by all stakeholders, and streamlining data collection and reporting.
|
From page 48... ...
Furthermore, the importance of establishing a public entity that would be responsible for identifying aims for quality improvement, setting national goals for measurement and reporting, and tracking progress was not fully recognized or supported by political will. In hindsight, this omission can be viewed as a missed opportunity.
|
From page 49... ...
Although a complete national infrastructure for standardized performance measurement and reporting has not emerged, major national standards-setting bodies, in concert with key public and private purchasers, have taken important actions to focus and harmonize measurement efforts. Much of this collaborative work has focused on performance measurement for physician practices -- a particularly challenging problem for several reasons.
|
From page 50... ...
The alliance has endorsed a standardized set of 26 measures for physician practices that draws heavily on the 2004 ambulatory care clinical performance measure set released by the Physician Consortium for Performance Improvement, CMS, and NCQA, thereby eliminating duplication (ACP, 2005)
|
From page 51... ...
In yet another collaborative effort, CMS has furthered its commitment to advancing measure development by awarding a contract for specialty and subspecialty measure development to Mathematica Policy, in collaboration with the Physician Consortium for Performance Improvement and NCQA, starting October 1, 2005. This represents what could be a new level of collaboration around measure development between private-sector entities and CMS (CMS, 2005a)
|
From page 52... ...
Although performance measurement and reporting systems are tailored to each country's political, social, and economic context, much can be learned from those experiences. For one thing, performance measurement in other countries demonstrates the potential value of centralized leadership and a streamlined, coordinated approach.
|
From page 53... ...
The evidence base for quality improvement, public reporting, and pay for performance is thin, and will remain so without cogent and well-supported evaluation. Creating a coherent national system that can help stakeholder groups work more effectively, respond to their various needs, and address gaps in leading measure sets is a major challenge.
|
From page 54... ...
· Continually evaluate, through an impact assessment, the effectiveness of performance measurement, payment reform, and quality improvement initiatives. 3The board's final report consisted of a series of papers published in Medical Care Supplement, Volume 41, No.
|
From page 55... ...
Capacity to learn -- Efforts to improve quality Evaluate the effectiveness of performance constrained by a lack of evidence on the measurement, public reporting, and payment effectiveness of alternative improvement systems and quality improvement initiatives strategies, potential adverse effects of to minimize potential adverse effects, detect measurement, best ways to communicate unintended consequences, and maximize quality information to providers and con- the eventual benefits of performance sumers, and effectiveness of pay-for- measurement. performance initiatives.
|
From page 56... ...
· Quality improvement -- Stakeholders engaged in the delivery of health care services need information they can act upon to improve the quality of those services. Clinicians need performance data to support on
|
From page 57... ...
Through its deliberations and its examination of existing measure sets (described more fully in Chapter 4) , the committee formulated 10 design principles for a progressively improving national performance measurement and reporting system.
|
From page 58... ...
Principle 4: Supportive of Multiple Uses A performance measurement system should and Stakeholders provide information for multiple uses, includ ing provider-led improvement efforts, public reporting, payment and benefit design, and population health initiatives. Principle 5: Measurement Intrinsic to Care Performance measurement should be intrin sic to the care process.
|
From page 59... ...
AMA (CQI) Measurement Sets: Clinical Performance Measurement Tools to Support Physicians in Their Efforts to Enhance the Quality of Patient Care.
|
From page 60... ...
McClellan, M.D., Ph.D. Administrator, CMS on Ambulatory Care Quality Measures.
|
From page 61... ...
2004a. National Voluntary Consensus Standards for Nursing-Sensitive Care: An Initial Performance Measure Set.
|
From page 62... ...
2004. Clinical Performance Measure ment Tools to Support Physicians in Their Efforts to Enhance the Quality of Patient Care: A Consensus Statement from The American Medical Association and The Joint Commission on Accreditation of Healthcare Organizations and The National Committee for Quality Assurance.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.