Spring Membership Meeting: An Update on NQF Janet M. Corrigan, PhD President and CEO National Quality Forum

2 Presentation At A Glance The Administration’s Emerging Quality Agenda NQF’s Role –Congressional Directive & DHHS Contract NQF’s Major Areas of Work: The Road Ahead –National Priorities Partnership –Portfolio of Performance Measures –Building EHRs/PHRs to Support Performance Improvement Healthcare Reform: Stand For Quality

3 The Administration’s Emerging Quality Agenda Stimulus Package (ARRA): Roughly $1 in $5 goes to health care Comparative effectiveness ($1.1B) HIT ($19.2B) Prevention/wellness ($1B) HAI ($50M) Hospice – delay reductions in Medicare payments

4 The Administration’s Emerging Quality Agenda 2010 Budget: 30-day readmissions –Hospitals to receive bundled payment including 30-day post acute care Payment –Continued P4P for Hospitals ($12B savings over 10 yrs) –Turbocharged Payment Demos

5 NQF Role July 2008 Congressional Directive to DHHS Contract with consensus standard-setting body to –Set national priorities –Endorse and maintain measures –Promote development of EHRs capable of supporting quality January 2009 –NQF received contract –$10M per year for up to 4 years

7 National Priorities Population health - Key preventive services - Healthy lifestyle behaviors Safety –Hospital-level mortality rates –Serious adverse events –Healthcare-Acquired Infections Care Coordination –Medication reconciliation –Preventable hospital readmissions –Preventable emergency department visits Patient/family engagement –Informed decision-making –Patient experience of care –Patient self-management Palliative Care: –Relief of physical symptoms –Help with psychological, social and spiritual needs –Communication regarding treatment options, prognosis –Access to palliative care services Overuse –9 major areas

8 Driving to achieve results… Performance Measurement Payment Accreditation & Certification COLLABORATIVE, ACTION-ORIENTED STRATEGIES Information Technology & Workforce Knowledge on Effective Health Care Delivery Public Reporting

9 National Priorities Two-dimensional Framework: NPP Crosscutting Priorities DHHS Contract Requests Prioritization of Leading Conditions (i.e., Patient-Focused Episodes)

10 Patient- Focused Episode Framework: Low Back Pain Follow-up Care & Prevention Episode begins – onset of symptoms Trajectory 2 (T2) Patient at risk for long- term chronic disability Focus on: Quality of Life Functional Status Patient-generated goals Population at Risk Adults with back pain Surgery or Medical Treatment Episode ends – 1 year Patient baseline assessment of function, mental health & comorbidities PHASE 1 PHASE 2 PHASE 4PHASE 5 PHASE 3 Shared Decision Making & Informed Choice Trajectory 1 (T1) Returning back to work & assuming normal activities of daily living Focus on: Quality of Life Functional Status Patient-generated goals Education & prevention of future episodes Diagnosis & Initial Management

Consensus Development Process - Update Recently Completed Projects (last 6 months) Safe practices for better healthcare Cultural competency framework and practices Therapeutic drug management practices Structural measures for health IT Emergency care Imaging efficiency Perinatal care Ongoing Projects Home health measures Hospital outcomes and efficiency Medication management Care coordination practices & measures Clinically enriched administrative data measures Laboratory safety and communication practices Pressure ulcer framework

12 Building EHRs to Support Quality Clinical Guidelines Decision Support Quality Measures Acknowledgement: Paul Tang, MD

HITEP 13

14 Data Types Needed for Quality Measures

15 Measures to Assess Effective Use of EHRs e-prescribing decision support (including stand-alone/non-EHR applications) in EHR EHR interoperability adoption of CCHIT or core-functional EHR receive labs electronically care management at point of care between visits quality reporting registry local national medical home

Stand for Quality Building a Foundation for High Quality, Affordable Health Care: Linking Performance Measurement to Health Reform. 160 supporting organizations Six key recommendations: –Set national priorities and provide coordination –Endorse/maintain measures –Support measure development –Establish multi-stakeholder consultative process on use of measures –Data aggregation and reporting –Identify “best practices” for quality improvement 16

17 NQF Senior Management Team Karen Adams, National Priorities Alicia Aebersold, Communications Helen Burstin, Measurement Floyd Eisenberg, HIT Bruce Pelleu, Finance and Administration

18 Staff Responsible for Spring Meeting and Conference Sarah Callahan Dwight McNeill Lauren Murray Dan Rafter Leslie Reeder-Thompson Michelle Robinson

The NQF Team 19

20 For More Information: