User login
The Centers for Medicare & Medicaid Services and America’s Health Insurance Plans on Feb 16 announced a set of core quality measures across seven areas that will serve as the foundation for a more uniform set of quality metrics that will be used by both public and private payers.
The CMS and AHIP are working with the National Quality Forum, medical specialty societies, employer groups, and consumer groups under an umbrella organization called the Core Quality Measures Collaborative. Together, they derived a set of measures that are “meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost,” the CMS noted in a fact sheet.
Involved medical specialty societies include the American Academy of Family Physicians, American College of Cardiology, American Heart Association, American College of Physicians, American Gastroenterological Association, HIV Medicine Association, Infectious Diseases Society of America, American Academy of Pediatrics, American Society of Clinical Oncology, and the American Medical Association.
The collaborative announced core measures in seven areas: accountable care organizations/patient centered medical homes/primary care, cardiology, gastroenterology, HIV and hepatitis C, medical oncology, obstetrics and gynecology, and orthopedics. Measures in additional areas will be released in the future and the core sets will be reviewed and updated on a regular basis.
“I think [this collaboration] strikes the best balance between what is feasible and what is desirable,” Dr. Ziad Gellad, chair of the AGA Quality Measures Committee, said in an interview.
For Medicare, Medicaid, and other public programs, the measure sets will be implemented and updated through the physician fee schedule in the coming Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs). Private payers are expected to begin implementing these quality measures as physician contracts come up for renewal.
“I think one of the biggest challenges will be how to collect these measures, because the decision about what measures to include was only driven in part by the feasibility,” Dr. Gellad said. “A large part was driven by what are the best metrics and what are most important outcomes and processes to evaluate. I think in terms of feasibility, that is going to be the next important question. How do you improve the feasibility of these measurements in practice?”
Electronic health records will play an integral part, as a FAQ released by AHIP notes that several of the measures “require that clinical data be extracted from EHRs or registries or be self-reported by clinicians.” It adds that clinicians and payers “will need to work together to create a reporting infrastructure for such measures” in areas where it is currently lacking.
HIV/Hep C measures get thumbs up
The Infectious Disease Society of America is on-board with the first set of quality metrics around HIV and hepatitis C released by the Core Quality Measures Collaborative, but it will be looking for more diseases and conditions in the future.
Consensus from the collaborative includes measures in HIV related to pneumocystis jiroveci pneumonia prophylaxis, sexually transmitted disease screening, HIV viral load suppression, HIV medical visit frequency, annual cervical cancer screening, and HIV screening of STI patients.
For hepatitis C, measures include screening for hepatocellular carcinoma in patients with hepatitis C cirrhosis and one-time screening for patients at risk for HCV.
With regard to these measure sets, “We don’t think there is anything missing,” Andres Rodriguez, director for practice & policy at the Infectious Diseases Society of America, said in an interview. “Certainly there is more to be done in the realm of infectious diseases and the issue there is, and we are working this, is involving more quality measures for infectious diseases and conditions. As they get incorporated into quality programs on the CMS side, we would then hope to have them transfer over to the commercial side.”
Current plans at the moment only address future HIV/hepatitis C measures.
GI quality measures target endoscopy, IBD, and hep C
The first set of quality measures related to gastroenterology focus on three areas: inflammatory bowel disease, endoscopy and polyp surveillance, and hepatitis C.
In the inflammatory bowel disease measure set, consensus was reached on two measures: dealing with preventive care (corticosteroid-related iatrogenic injury – bone loss assessment) and an assessment of hepatitis B status before initiating anti–tumor necrosis factor therapy.
The five measures in the endoscopy and polyp surveillance set all relate to colonoscopy: appropriate follow-up interval for normal colonoscopy in average-risk patients; colonoscopy interval for patients with a history of adenomatous polyps; avoidance of inappropriate use; screening colonoscopy adenoma detection rate measure; and age-appropriate screening colonoscopy.
Two measures in the hepatitis C measure set include screening for hepatocellular carcinoma in patients with hepatitis C cirrhosis and one-time screening for hepatitis C virus for patients at risk.
Future areas for consideration of measure development include chronic liver disease, colorectal cancer screening, adverse events related to colonoscopy, assessing the quality of colonoscopy, gastroesophageal reflux disease and cirrhosis measures, and Barrett’s esophagus.
“I think it is an appropriate set of metrics for gastroenterology and hepatology,” said Dr. Gellad. “It was a collaborative approach. We had influence over the measures that were chosen for our specialty, but not the final say.”
The Centers for Medicare & Medicaid Services and America’s Health Insurance Plans on Feb 16 announced a set of core quality measures across seven areas that will serve as the foundation for a more uniform set of quality metrics that will be used by both public and private payers.
The CMS and AHIP are working with the National Quality Forum, medical specialty societies, employer groups, and consumer groups under an umbrella organization called the Core Quality Measures Collaborative. Together, they derived a set of measures that are “meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost,” the CMS noted in a fact sheet.
Involved medical specialty societies include the American Academy of Family Physicians, American College of Cardiology, American Heart Association, American College of Physicians, American Gastroenterological Association, HIV Medicine Association, Infectious Diseases Society of America, American Academy of Pediatrics, American Society of Clinical Oncology, and the American Medical Association.
The collaborative announced core measures in seven areas: accountable care organizations/patient centered medical homes/primary care, cardiology, gastroenterology, HIV and hepatitis C, medical oncology, obstetrics and gynecology, and orthopedics. Measures in additional areas will be released in the future and the core sets will be reviewed and updated on a regular basis.
“I think [this collaboration] strikes the best balance between what is feasible and what is desirable,” Dr. Ziad Gellad, chair of the AGA Quality Measures Committee, said in an interview.
For Medicare, Medicaid, and other public programs, the measure sets will be implemented and updated through the physician fee schedule in the coming Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs). Private payers are expected to begin implementing these quality measures as physician contracts come up for renewal.
“I think one of the biggest challenges will be how to collect these measures, because the decision about what measures to include was only driven in part by the feasibility,” Dr. Gellad said. “A large part was driven by what are the best metrics and what are most important outcomes and processes to evaluate. I think in terms of feasibility, that is going to be the next important question. How do you improve the feasibility of these measurements in practice?”
Electronic health records will play an integral part, as a FAQ released by AHIP notes that several of the measures “require that clinical data be extracted from EHRs or registries or be self-reported by clinicians.” It adds that clinicians and payers “will need to work together to create a reporting infrastructure for such measures” in areas where it is currently lacking.
HIV/Hep C measures get thumbs up
The Infectious Disease Society of America is on-board with the first set of quality metrics around HIV and hepatitis C released by the Core Quality Measures Collaborative, but it will be looking for more diseases and conditions in the future.
Consensus from the collaborative includes measures in HIV related to pneumocystis jiroveci pneumonia prophylaxis, sexually transmitted disease screening, HIV viral load suppression, HIV medical visit frequency, annual cervical cancer screening, and HIV screening of STI patients.
For hepatitis C, measures include screening for hepatocellular carcinoma in patients with hepatitis C cirrhosis and one-time screening for patients at risk for HCV.
With regard to these measure sets, “We don’t think there is anything missing,” Andres Rodriguez, director for practice & policy at the Infectious Diseases Society of America, said in an interview. “Certainly there is more to be done in the realm of infectious diseases and the issue there is, and we are working this, is involving more quality measures for infectious diseases and conditions. As they get incorporated into quality programs on the CMS side, we would then hope to have them transfer over to the commercial side.”
Current plans at the moment only address future HIV/hepatitis C measures.
GI quality measures target endoscopy, IBD, and hep C
The first set of quality measures related to gastroenterology focus on three areas: inflammatory bowel disease, endoscopy and polyp surveillance, and hepatitis C.
In the inflammatory bowel disease measure set, consensus was reached on two measures: dealing with preventive care (corticosteroid-related iatrogenic injury – bone loss assessment) and an assessment of hepatitis B status before initiating anti–tumor necrosis factor therapy.
The five measures in the endoscopy and polyp surveillance set all relate to colonoscopy: appropriate follow-up interval for normal colonoscopy in average-risk patients; colonoscopy interval for patients with a history of adenomatous polyps; avoidance of inappropriate use; screening colonoscopy adenoma detection rate measure; and age-appropriate screening colonoscopy.
Two measures in the hepatitis C measure set include screening for hepatocellular carcinoma in patients with hepatitis C cirrhosis and one-time screening for hepatitis C virus for patients at risk.
Future areas for consideration of measure development include chronic liver disease, colorectal cancer screening, adverse events related to colonoscopy, assessing the quality of colonoscopy, gastroesophageal reflux disease and cirrhosis measures, and Barrett’s esophagus.
“I think it is an appropriate set of metrics for gastroenterology and hepatology,” said Dr. Gellad. “It was a collaborative approach. We had influence over the measures that were chosen for our specialty, but not the final say.”
The Centers for Medicare & Medicaid Services and America’s Health Insurance Plans on Feb 16 announced a set of core quality measures across seven areas that will serve as the foundation for a more uniform set of quality metrics that will be used by both public and private payers.
The CMS and AHIP are working with the National Quality Forum, medical specialty societies, employer groups, and consumer groups under an umbrella organization called the Core Quality Measures Collaborative. Together, they derived a set of measures that are “meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost,” the CMS noted in a fact sheet.
Involved medical specialty societies include the American Academy of Family Physicians, American College of Cardiology, American Heart Association, American College of Physicians, American Gastroenterological Association, HIV Medicine Association, Infectious Diseases Society of America, American Academy of Pediatrics, American Society of Clinical Oncology, and the American Medical Association.
The collaborative announced core measures in seven areas: accountable care organizations/patient centered medical homes/primary care, cardiology, gastroenterology, HIV and hepatitis C, medical oncology, obstetrics and gynecology, and orthopedics. Measures in additional areas will be released in the future and the core sets will be reviewed and updated on a regular basis.
“I think [this collaboration] strikes the best balance between what is feasible and what is desirable,” Dr. Ziad Gellad, chair of the AGA Quality Measures Committee, said in an interview.
For Medicare, Medicaid, and other public programs, the measure sets will be implemented and updated through the physician fee schedule in the coming Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs). Private payers are expected to begin implementing these quality measures as physician contracts come up for renewal.
“I think one of the biggest challenges will be how to collect these measures, because the decision about what measures to include was only driven in part by the feasibility,” Dr. Gellad said. “A large part was driven by what are the best metrics and what are most important outcomes and processes to evaluate. I think in terms of feasibility, that is going to be the next important question. How do you improve the feasibility of these measurements in practice?”
Electronic health records will play an integral part, as a FAQ released by AHIP notes that several of the measures “require that clinical data be extracted from EHRs or registries or be self-reported by clinicians.” It adds that clinicians and payers “will need to work together to create a reporting infrastructure for such measures” in areas where it is currently lacking.
HIV/Hep C measures get thumbs up
The Infectious Disease Society of America is on-board with the first set of quality metrics around HIV and hepatitis C released by the Core Quality Measures Collaborative, but it will be looking for more diseases and conditions in the future.
Consensus from the collaborative includes measures in HIV related to pneumocystis jiroveci pneumonia prophylaxis, sexually transmitted disease screening, HIV viral load suppression, HIV medical visit frequency, annual cervical cancer screening, and HIV screening of STI patients.
For hepatitis C, measures include screening for hepatocellular carcinoma in patients with hepatitis C cirrhosis and one-time screening for patients at risk for HCV.
With regard to these measure sets, “We don’t think there is anything missing,” Andres Rodriguez, director for practice & policy at the Infectious Diseases Society of America, said in an interview. “Certainly there is more to be done in the realm of infectious diseases and the issue there is, and we are working this, is involving more quality measures for infectious diseases and conditions. As they get incorporated into quality programs on the CMS side, we would then hope to have them transfer over to the commercial side.”
Current plans at the moment only address future HIV/hepatitis C measures.
GI quality measures target endoscopy, IBD, and hep C
The first set of quality measures related to gastroenterology focus on three areas: inflammatory bowel disease, endoscopy and polyp surveillance, and hepatitis C.
In the inflammatory bowel disease measure set, consensus was reached on two measures: dealing with preventive care (corticosteroid-related iatrogenic injury – bone loss assessment) and an assessment of hepatitis B status before initiating anti–tumor necrosis factor therapy.
The five measures in the endoscopy and polyp surveillance set all relate to colonoscopy: appropriate follow-up interval for normal colonoscopy in average-risk patients; colonoscopy interval for patients with a history of adenomatous polyps; avoidance of inappropriate use; screening colonoscopy adenoma detection rate measure; and age-appropriate screening colonoscopy.
Two measures in the hepatitis C measure set include screening for hepatocellular carcinoma in patients with hepatitis C cirrhosis and one-time screening for hepatitis C virus for patients at risk.
Future areas for consideration of measure development include chronic liver disease, colorectal cancer screening, adverse events related to colonoscopy, assessing the quality of colonoscopy, gastroesophageal reflux disease and cirrhosis measures, and Barrett’s esophagus.
“I think it is an appropriate set of metrics for gastroenterology and hepatology,” said Dr. Gellad. “It was a collaborative approach. We had influence over the measures that were chosen for our specialty, but not the final say.”
