NCQA to evaluate new clinical quality measurement tool

With a grant from the Robert Wood Johnson Foundation, the National Committee for Quality Assurance plans to spend 18 months evaluating a new measurement tool aimed at prevention among heart disease and diabetes patients.

The tool, called the "Global Cardiovascular Risk" (GCVR) score, is being created with data modeling and analytics vendor Archimedes. It will draw clinical information from electronic health records to determine how well providers reduce the risk of future adverse outcomes, according to an announcement.

"This new tool has the potential to become the first customized, outcomes-based electronic health record measure used by Medicare and commercial payers," NCQA President Margaret E. O'Kane said. "Its widespread adoption could have a profound impact on healthcare costs because it assesses how well providers engage in prevention and goal-setting for their high-risk patients."

Currently, physicians focus on reaching goal biomarkers, and there's little quantitative data on how patients fare long term under the care they receive. This tool aims to measure--and come up with a single metric--to show how much the risk of future adverse events has been reduced.

That means collecting data and coming up with a measurable result for different providers and provider organizations. The NCQA also plans to evaluate provider views on how valuable the GCVR score is for predicting risk. One of the goals for the program is to make it easier to come up with incentives for providers to reduce future risk.

Beyond improving patients' lives, the tool is expected to help control healthcare costs by reducing the need for hospitalization, tests and procedures.

The NCQA is recruiting organizations to participate as it determines how to extract data from various EHRs to create this quality measure. It plans to collect and analyze data through the summer and fall, and report on its findings by summer 2014.

An Institute of Medicine report on the difficulties faced by returning veterans was the latest call for evidence-based treatment. It criticized the U.S. Departments of Defense and Veterans Affairs for using unproven diagnostic and therapy tools.

A recent study published in Health Affairs called for greater focus on clinical quality rather than financial performance from U.S. hospital boards. A Chinese study, meanwhile, found evidence-based clinical pathways to reduce overtreatment without significantly reducing the hospital revenues.

To learn more:
- here's the announcement


Fuel Top Line Growth and Increase Membership

In this webinar, payers can learn how to accelerate the sales pipeline and grow membership across all health insurance market segments using comprehensive sales technologies.