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NQF Updates Viral Disease Care Measures

 |  By cclark@healthleadersmedia.com  
   January 09, 2013

The National Quality Forum on Tuesday endorsed four new measures for HIV care and re-validated 10 other measures designed to improve the way physicians treat other viral illnesses such as HIV and hepatitis.

About 1.2 million Americans now live with HIV infection, and healthcare spending on medical care, research and prevention totaled $21.3 billion in 2011, according to statistics maintained by the Kaiser Family Foundation. The four new HIV measures join another eight NQF endorsed measures for HIV care.

Among the four new endorsed measures, designed so that health plans and other payers might improve quality of care based on accepted evidence-based practice, are tracking the percentage of patients who regardless of age, and with a diagnosis of HIV:

  • Had at least one medical visit in each 6-month period of the 24-month measurement period with a minimum of 60 days between medical visits, to determine medical visit frequency.
  • Did not have a medical visit in the last 6 months of the measurement year.
  • Had an HIV viral load less than 200 copies/mL at the last test during the measurement year to determine viral load suppression.
  • Are prescribed antiretroviral therapy during the measurement year, to make sure patients are receiving prescription medications.

In a statement, Helen Burstin, MD, NQF's senior vice president for performance measures, said the measures are "essential in helping providers evaluate patients, manage appropriate treatments and ultimately improve patient care."

According to the statement, Steven J. Brotman, MD, JD, senior vice president for payment and healthcare delivery policy at The Advanced Medical Technology (AdvaMed) and co-chair of the Infectious Disease Endorsement Steering Committee, "These measures—thoroughly evaluated by a diverse group of infectious disease experts—focus on helping individuals stay healthy and treating disease earlier and more effectively, which will be instrumental to reducing unnecessary healthcare costs."

The remaining 10 measures have been endorsed for at least three years, but have been re-endorsed and in some cases updated.

They are:

  • The percentage of adults 18–64 years of age with a diagnosis of acute bronchitis (usually a viral illness) who were not dispensed an antibiotic prescription.
  • The percentage of children 3 months to 18 years of age with a diagnosis of URI who were not dispensed an antibiotic medication.
  • The percentage of patients aged 18 years and older with a diagnosis of chronic hepatitis C who are receiving antiviral treatment for whom quantitative HCV RNA testing was performed within 6 months prior to initiation of antiviral treatment.
  • The percentage of patients aged 18 years and older with a diagnosis of chronic hepatitis C who are receiving antiviral treatment for whom HCV genotype testing was performed prior to initiation of antiviral treatment.

  • The percentage of patients aged 18 years and older with a diagnosis of chronic hepatitis C who are receiving antiviral treatment for whom quantitative HCV RNA testing was performed at no greater than 12 weeks from initiation of antiviral treatment.
  • The percentage of patients aged 18 years and older with a diagnosis of hepatitis C who have received at least one injection of hepatitis A vaccine, or who have documented immunity to hepatitis A.
  • The percentage of patients aged six months and older with a diagnosis of HIV/AIDS, with at least two CD4 cell counts or percentages performed during the measurement year at least 3 months apart.
  • The percentage of patients aged 6 weeks or older with a diagnosis of HIV/AIDS, who were prescribed Pneumocystis jiroveci (formerly carinii) pneumonia (PCP) prophylaxis.
  • The percentage of patients aged 3 months and older with a diagnosis of HIV/AIDS, for whom there was documentation that a tuberculosis (TB) screening test was performed and results interpreted (for tuberculin skin tests) at least once since the diagnosis of HIV infection.
  • The percentage of patients aged 13 years and older with a diagnosis of HIV/AIDS, who have received chlamydia, gonorrhea, and syphilis screenings at least once since the diagnosis of HIV infection.

The NQF currently has endorsed about 700 measures.  In this round of measure candidates, some 34 care processes or activities were considered. Seven were withdrawn and two remain under consideration.

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