Secretarial Review and Publication of the National Quality Forum Annual Report to Congress and the Secretary Submitted by the Consensus-Based Entity…
Secretarial Review and Publication of the National Quality Forum Annual Report to
SUMMARY: This notice acknowledges the Secretary of the
FOR FURTHER INFORMATION CONTACT:
The order in which information is presented in this notice is as follows:
I. Background
II. The 2016 Annual Report to
III. Secretarial Comments on the 2016 Annual Report to
IV. Collection of Information Requirements
I. Background
The Patient Protection and Affordable Care Act of 2010 (ACA) provides strategies and tools to more fully achieve " Quality, Affordable Health Care For All Americans "--Title I of ACA. In the six years since its passage, 20 million people have gained access to health care, (See ASPE. "HEALTH INSURANCE COVERAGE AND THE AFFORDABLE CARE ACT, 2010-2016 available at: https://aspe.hhs.gov/pdf-report/health-insurance-coverage-and-affordable-care-act-2010-2016") and the quality of that care is significantly improved. Fewer Americans are losing their lives or falling ill due to conditions acquired in the hospital such as pressure ulcers, infections, falls and traumas. Hospital-acquired conditions are estimated to have declined by 17 percent between 2010 and 2014. Preliminary data show that between 2010 and 2014, there was a decrease in these conditions by more than 2.1 million events; and as a result, 87,000 fewer people lost their lives. See: "Saving Lives and Saving Money: Hospital-Acquired Conditions Update."
A key ACA strategy for " Improving The Quality and Efficiency of Health Care" (Title III of ACA) is to transform the health care delivery system by encouraging development of new patient care models and linking payment to quality outcomes in the
Efforts to transform the health care system to provide higher quality care require accurate, valid, and reliable measurement of the quality and efficiency of health care. Recognition of the need for such measurement predates ACA; MIPPA created section 1890 of the Social Security Act (the Act), which requires the Secretary of HHS to contract with a CBE to perform multiple duties to help improve performance measurement. Section 3014 of ACA expanded the duties of the CBE to help in the identification of gaps in available measures and to improve the selection of measures used in health care programs.
In response to MIPPA, in January of 2009, a competitive contract was awarded by HHS to the
Priority Setting Process: Formulation of a National Strategy and Priorities for Health Care Performance Measurement. The CBE is to synthesize evidence and convene key stakeholders to make recommendations on an integrated national strategy and priorities for health care performance measurement in all applicable settings. In doing so, the CBE is to give priority to measures that: (a) Address the health care provided to patients with prevalent, high-cost chronic diseases; (b) have the greatest potential for improving quality, efficiency and patient-centered health care; and c) may be implemented rapidly due to existing evidence, standards of care or other reasons. Additionally, the CBE must take into account measures that: (a) May assist consumers and patients in making informed health care decisions; (b) address health disparities across groups and areas; and (c) address the continuum of care across multiple providers, practitioners and settings.
Endorsement of Measures: The CBE is to provide for the endorsement of standardized health care performance measures. This process must consider whether measures are evidence-based, reliable, valid, verifiable, relevant to enhanced health outcomes, actionable at the caregiver level, feasible to collect and report, responsive to variations in patient characteristics such as health status, language capabilities, race or ethnicity, and income level and are consistent across types of health care providers, including hospitals and physicians.
Maintenance of CBE Endorsed Measures. The CBE is required to establish and implement a process to ensure that endorsed measures are updated (or retired if obsolete) as new evidence is developed.
Review and Endorsement of an Episode Grouper Under the Physician Feedback Program. " Episode-based" performance measurement is an approach to better understanding the utilization and costs associated with a certain condition by grouping together all the care related to that condition. "Episode groupers" are software tools that combine data to assess such condition-specific utilization and costs over a defined period of time. The CBE is required to provide for the review, and as appropriate, endorsement of an episode grouper as developed by the Secretary.
Convening Multi-Stakeholder Groups. The CBE must convene multi-stakeholder groups to provide input on: (1) The selection of certain categories of quality and efficiency measures, from among such measures that have been endorsed by the entity; and such measures that have not been considered for endorsement by such entity but are used or proposed to be used by the Secretary for the collection or reporting of quality and efficiency measures; and (2) national priorities for improvement in population health and in the delivery of health care services for consideration under the national strategy. The CBE provides input on measures for use in certain specific
Transmission of Multi-Stakeholder Input. Not later than
Annual Report to
(i) The implementation of quality and efficiency measurement initiatives and the coordination of such initiatives with quality and efficiency initiatives implemented by other payers;
(ii) recommendations on an integrated national strategy and priorities for health care performance measurement;
(iii) performance of the CBE's duties required under its contract with HHS;
(iv) gaps in endorsed quality and efficiency measures, including measures that are within priority areas identified by the Secretary under the national strategy established under section 399HH of the Public Health Service Act (National Quality Strategy), and where quality and efficiency measures are unavailable or inadequate to identify or address such gaps;
(v) areas in which evidence is insufficient to support endorsement of quality and efficiency measures in priority areas identified by the Secretary under the National Quality Strategy, and where targeted research may address such gaps; and
(vi) the convening of multi-stakeholder groups to provide input on: (1) The selection of quality and efficiency measures from among such measures that have been endorsed by the CBE and such measures that have not been considered for endorsement by the CBE but are used or proposed to be used by the Secretary for the collection or reporting of quality and efficiency measures; and (2) national priorities for improvement in population health and the delivery of health care services for consideration under the National Quality Strategy.
The statutory requirements for the CBE to annually report to
--This is a summary of a
Notice.
Citation: "81 FR 60996"
Federal Register Page Number: "60996"
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