CQMC has also published a measurement gap and alignment analysis that calls for new health equity measures and digital approaches to speed outcomes tracking.
The Core Quality Measures Collaborative (CQMC) has updated five of its measure sets to improve physician performance and patient outcomes under value-based contracts. New and deleted metrics—in addition to telehealth-related updates across multiple measures—were part of the periodic refresh by the CQMC, a public-private collaboration between AHIP and CMS with guidance from the National Quality Forum (NQF). With the update, the CQMC also published a measurement gap and alignment analysis that called for new health equity measures and digital approaches to speed and strengthen outcomes tracking.
In the related press release, AHIP notes that the CQMC core measure sets are consensus- and evidence-based "to promote alignment across public and private payers within value-based contracts." Highlights from the five measure set changes include telehealth-applicable updates and the following:
1. Accountable Care Organizations/Patient Centered Medical Homes/Primary Care (ACO/PCMH/PC). Refined and enriched Comprehensive Diabetes Care metrics to focus on HbA1c control over testing. Align kidney health assessment with current clinical guidelines and other measurement programs.
2. Behavioral Health. Added diabetes screenings for people who have schizophrenia or bipolar disorder and are taking antipsychotic medications.
3. Cardiology. Added measures for assessments of congestive heart failure functional status assessments and ischemic vascular disease monitoring. Removed measures related to youth cardiac catheterization and cardiac stress imaging that are either no longer NQF endorsed or have consistently high performance.
4. Obstetrics & Gynecology. Added measures for postpartum depression screen and follow-up, prenatal immunization status, and birth control counseling. Removed metrics that are either retired or no longer maintained.
5. Orthopedics. Added metrics to address previously identified gaps related to ambulatory care treatment and patient outcomes related to neck/low-back impairments and hip/knee arthroplasty.
The CQMC's five additional data sets include: Gastroenterology, HIV & Hepatitis C, Medical Oncology, Neurology, and Pediatrics.
"With these changes," says AHIP SVP Danielle Lloyd, "the CQMC is furthering its goals of ensuring patients are receiving patient-centered, evidence-based, high-quality, and coordinated care while reducing provider burden through aligned measurement in key clinical areas." Lloyd helps lead AHIP’s private market innovations and quality initiatives and is the CQMC's Steering Committee co-chair.
Reducing burden means providing physicians with the information they need—when and how they need it—to pivot their performance. This could include expanding the data sources for digital quality measures beyond claims records and the technologies used to collect and analyze them.
About this, Lloyd adds: "As we expand performance measurement, it is critical that we move to digital measurement to reduce the resources required and get the information in front of the physicians when it counts."
Digital reporting recommendations were included in the CQMC's annual Analysis of Measurement Gap Areas and Measure Alignment report. The analysis identified gaps related to specific measures and common to multiple ones, opportunities to align metrics, and areas under development. The CQMC described the need for:
- More advanced outcome measures, including those informed by patient self-reporting
- Measures that span multiple conditions and care levels, as well as episode, population, and provider types
- ACO-specific measures that align with other measure sets, such as behavioral health and cardiology
The annual report also recommended health equity improvements, including defining new measures, stratifying existing ones "to identify where healthcare disparities may exist for vulnerable populations" and defining areas in which inequity is persistent.
Laura Beerman is a freelance writer for HealthLeaders.