Physician Practice

CMS, AHIP standardize quality measures

Physician Practice Insider, February 23, 2016

Seven measure sets aim to alleviate the burden and cost of measuring clinical quality and will "support multi-payer alignment, for the first time, on core measures primarily for physician quality programs," says CMS.

Responding to complaints of excessive, conflicting, and meaningless quality reporting requirements, CMS and representatives of the private insurance industry have agreed to use a single set of healthcare quality measures.

CMS says that the measures "support multi-payer alignment, for the first time, on core measures primarily for physician quality programs."

CMS acting administrator Andy Slavitt and America’s Health Insurance Plan’s (AHIP) Executive Vice President Carmella Bocchino announced the seven "core measures" on a teleconference February 16.

Slavitt acknowledged a consensus on the need for quality measures. The push for quality, however, has translated into an array of confusing and sometime overlapping measurement and reporting requirements "often adding to physician burden and weakening the signal of the importance of quality," he said. "Everywhere you go in healthcare, people universally ask for one thing: simplify, simplify, simplify."

CMS is already using many of the core measures and will add new measures "as appropriate while eliminating redundant measures," Slavitt said. The goal is to get private plans to phase the new measures into new and renewed contracts.

The group behind the effort called the Core Quality Measures Collaborative consists of purchasers, providers, and consumers. Also at the announcement: Douglas E. Henley, MD, of the American Academy of Family Physicians representing providers, and Carol Sakala of the National Partnership for Women & Families, who spoke for consumers. Stephen Ondra represented the Health Care Service Corporation, which is affiliated with Blue Cross and Blue Shield.

Bocchino said that the effort underscores the importance of partnerships and called it "a major step forward for alignment of quality measures."

The group said the collaborative represents 70% of all healthcare payers, including Aetna and UnitedHealth Group. (Those two insurers are no longer AHIP members, having left in 2015. AHIP is trying to get them to rejoin the powerful lobbying organization.)

Commercial payers have agreed to begin using the measures "as soon as feasible," according to the CMS announcement.

According to CMS: "The guiding principles used by the Collaborative in developing the core measure sets are that they be meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost. The goal is to establish broadly agreed upon core measure sets that could be harmonized across both commercial and government payers."

This article was originally published on HealthLeaders Media.

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