Panel Winnows Proposed Quality Measures For Medicare And Medicaid

Updated 12:25 p.m.

A panel of health care experts and industry officials has winnowed down 368 quality measures the Centers for Medicare & Medicaid Services is considering to use in evaluating nursing homes, hospitals, diabetes facilities and other providers. The panel said 45 percent of the potential measures it reviewed shouldn’t be used by the government when it sets new rules this year for how it is going to measure and pay health care providers.

As Capsules noted Tuesday, the measures CMS is considering were suggested by a variety of government bodies, industry groups and others. CMS asked a panel convened by the National Quality Forum to help it cull the list, and the panel’s draft report is now public.

According to the report, the panel, known as the Measure Applications Partnership, supported 40 percent of the measures. It said another 15 percent were good ideas in theory but needed to be refined and tested before the government considers adoption.

Many of the measures the panel recommended are ones CMS is considering using to enact  provisions in the 2010 health care law designed to monitor and change the health care system. Some of the measures are intended to evaluate care for poor people who are “dual eligibles” enrolled in both Medicaid and Medicare. “If we can address the thorny issues for this particularly vulnerable population, that will improve quality across the system,” said Dr. Thomas Valuck, a senior vice president at the forum.

You can read the list here. The panel’s recommendations are not binding on CMS, but they are likely to be influential. This is the first time the government has asked an outside group to make recommendations on quality measures it is considering, before the government formally proposes them. After the panel reviews public comments, it will submit a final report to CMS on Feb. 1.

jrau@kff.org

 

we can address the thorney issues for this particularly vulnerable due vulnerable, that will help improve quality across the system