NQF Releases Measure Recommendations for Federal Healthcare Programs

The National Quality Forum’s Measure Applications Partnership recently released guidelines on measures for the new Merit-Based Incentive Payment System and on cross-cutting issues for all federal healthcare programs.

The National Quality Forum (NQF)’s Measure Applications Partnership (MAP) recently released guidelines on measures for the new Merit-Based Incentive Payment System (MIPS) and on cross-cutting issues for all federal healthcare programs.

The recommendations, presented by MAP, for measures in these programs, reflect how well the measures address the identified program goals, as well as NQF’s prior work in identifying families of measures. Some of the dominating issues for clinician programs identified included: the new MIPS aligning all clinician measures into a single program; further alignment of clinician measures warranted with alternative payment model and hospital/facility measures; increased public reporting of clinician measures on Physician Compare; and measuring gaps in both MIPS and Medicare Shared Savings Program.

For the purpose of the review, MAP considered 60 performance measures for use in MIPS. MIPS is a program legislated by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) in CMS. MIPS combines the Physician Quality Reporting System, the Value Modifier, and the Medicare Electronic Health Record incentive program into a single program. This single program is responsible for adjusting eligible providers’ Medicare payments based on performance.

“As the US healthcare system increasingly shifts to a performance-based payment system, MAP’s role as an impartial advisor bringing stakeholders together from across the healthcare spectrum is more important than ever,” said Helen Burstin, NQF’s chief scientific officer. “The recommendations MAP made for MIPS, MSSP, and other federal healthcare programs are advancing measurement to help make better healthcare a reality for all Americans.”

Exploring in detail, the following recommendations were proposed on cross-cutting issues to HHS:

  • It was proposed that alignment of measures across federal programs be made a priority. It is also important for CMS to pursue alignment of quality measures across the MIPS program and Alternative Payment Models, as well as alignment with states and the private sector where possible. This better alignment across programs was MAP’s rationale for supporting a depression screening measure for MIPS and MSSP that is similar to a measure used in private programs as well as the Adult and Child Core Sets for Medicaid.

  • Another recommendation was to measure gaps across clinician-level programs, especially in patient-centered areas such as patient-reported outcomes, functional status, and care coordination. Because MAP stresses on focusing on patients’ experience with the healthcare system to the impact of healthcare on patients’ health and wellbeing.
  • It is imperative to analyze and improve the impact of patients’ socioeconomic status and other demographic factors on measure results. Also, are providers caring for high-risk populations? MAP noted support for NQF’s two-year trial period to examine the impact of SES adjustment on measurement.

This report highlights major changes in the types of measures submitted for consideration for use and notes that this year, for the first time, more outcome measures were submitted for consideration than process measures.