ACHE 2015: Value-based care models heighten need for science-based measures

In today's rapidly changing industry, the healthcare quality movement's main challenge is to "reduce the noise and increase the signal strength" of measures used to assess hospitals and healthcare systems, National Quality Forum (NQF) CEO and President Christine Cassel, M.D., said during a luncheon Monday at the 2015 Congress of the American College of Healthcare Executives (ACHE).

The NQF was founded in 1999 following a congressional committee and engages more than 400 member organizations in its primary mission to endorse the best healthcare quality measures.

The NQF has also seen the healthcare industry go from having too few quality measures to having too many, Cassel (pictured right) said. Given this fact as well as the recently accelerated shift to value-based payment models, "it is even more important that we get the measures right," she added.

The primary issue with the recent proliferation of quality metrics is that many need to have more science behind them, Cassel said, citing the recent Health Affairs report that highlighted how widely varying hospital ranking systems may confuse consumers.

"No wonder consumers tend to ignore all this information--it's not really meaningful to them," she said. "And the question is, what can all of us do together to make that information more meaningful, to unpack the black box of some of those measurement organizations … to make the science of how they do their measurements more reliable, more credible to you [the providers] as well as more meaningful to the public."

Though it is difficult to measure healthcare quality improvements at the national level, NQF has been instrumental in a number of "dramatic gains," such as a 46 percent decrease in central-line infections in the last five years and a 73 percent reduction in early-elective deliveries of babies in the last 2½ years, both of which have saved lives and cut costs, Cassel said.

To continue to make such quality improvements, Cassel outlined the following core goals for NQF going forward:

  • Align quality measures among all payers
  • Identify more actionable, meaningful measures
  • Achieve greater consistency and rigor with consumer information
  • Leverage new technology and big data to identify and assess quality metrics
  • Make sure measure reflect actual clinical quality, not factors like socioeconomic status that are out of health systems' control
  • Attribute results to specific providers
  • Improve consumer engagement 

To the last point, Cassel noted that most people still use review sites like Yelp and Angie's List to assess healthcare providers rather than data collected by organizations like the NQF, "so we have a ways to go in creating information that is truly meaningful to them."

NQF's mission to identify the best care quality metrics was clouded last year when it became embroiled in a conflict-of-interest flap amid allegations that the company CareFusion paid Charles Denham, M.D., co-chair of the NQF's Safe Practices Committee at the time, more than $11 million to promote one of its products. The controversy resulted in an internal audit and revised sponsorship guidelines on the part of NQF as well as a legal settlement, FierceHealthcare reported.

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