NQF Identifies Efficient Care for 4 Conditions

In a statement, NQF president and CEO Janet Corrigan said "Healthcare spending in the United States continues to rise without any significant gains in patient satisfaction, increased access to care, or higher quality care. I'm confident that these additional measures—in conjunction with existing resource use measures in our portfolio—will help us better understand what is driving costs and create a more effective, efficient healthcare system."

The four new measures follow the endorsement in January of the first four under this contract.  Those are:

• Relative resource use for people enrolled in health plans and who have either type I or type II diabetes
• Relative resource use for people enrolled in health plans who have specific cardiovascular conditions including major cardiac events such as acute myocardial infarction, coronary artery bypass graft surgery and percutaneous coronary interventions as well as cardiovascular-related diagnoses such as ischemic vascular disease.
• A Resource Use Index (RUI), which is a measure of a primary care provider’s risk-adjusted frequency and intensity of services used to manage patients using standardized prices. Resource use includes all resources associated with treating members, including professional, facility inpatient and outpatient, pharmacy, laboratory, radiology, ancillary, and behavioral health services.
• A total cost of care population-based PMPM Index (HealthPartners).

This index includesthe total cost index (TCI), a measure of a primary care provider’s risk-adjusted cost effectiveness at managing the population they care for using actual prices paid by the health plan. TCI includes all costs associated with treating members, including professional, facility inpatient and outpatient, pharmacy, lab, radiology, ancillary, and behavioral health services.

The NQF's endorsement of a measure, or a similar organization's endorsement, is required before a measure of care may be included on Hospital Compare or used in the value-based purchasing algorithm.