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Aligning Quality Measure Sets Successful Use of Online Measure Selection Tool with 2015 Updates Gerry Shea, Michael Bailit, Christine Hughes, and Susan Schow February 24, 2015

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Welcome and Introduction 2 Gerry Shea Buying Value Project Director gshea@buyingvalue.org 202 256-7577 www.buyingvalue.org

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Asking Questions Due to the number of participants, we will not open the telephone lines for questions. Please use the webinar Q&A feature instead to ask questions. Roll over the green bar at the top of the page and left click on Q&A or Chat. Type your question in the box. Click on All Panelists in the Ask box. 3

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The Buying Value Project Buying Value is an RWJF-funded initiative of private health care purchasers employers, leading business health organizations, and union health funds that was launched in 2012. Mission Private purchasers contribute to better health and lower health costs by buying on value rather than on volume. Objective Enable widespread adoption of value purchasing in the private sector through alignment of measures among private purchasers and with federal and state public programs Strategy Measure Alignment Campaign Public and private purchasers, health plans, providers, and care delivery systems commit to core measure sets developed through multi-stakeholder consensus processes nationally, and at the regional or state level. Help for States/Other Stakeholders in Creating Aligned Measure Sets Online Measure Selection Tool and hands-on help. 4

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Buying Value Milestones Website www.buyingvalue.org (2012) -- Basic info on value- purchasing Primer, Legal Memo on Anti-Trust Issueswww.buyingvalue.org Starter Core Measure Set (March 2013) National purchasers, consumers, CMS & payers (health plans) Study of 48 Measure Sets in Use at State Level (2013) -- Only 20% of measures used by more than one program; 25% of shared measures modified in some way; 39% of measures either non-standard or homegrown Model for Consensus Core Measure Sets -- A multi-stakeholder, two-tier (national and regional or state) process for consensus core measure sets Online Measure Selection Tool (9/2014; Updated 1/2015) web-based spreadsheet linked to measure databases that enables those creating measure sets to view in one place a multitude of important decision factors. 5

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The State of (Mis)Alignment 6 2013 Buying Value study of state quality measure sets: Only 20% of measures used by more than one program 23% of shared measures modified in some way 39% of measures non-standardized or homegrown The result? Tremendous variation in the way we define and evaluate quality across the country.

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Measure Alignment Work: Federal Agencies To Cut 94% of Measures in Seven Key Areas! 7 7

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Other Measure Alignment Work CMMI State Innovation Model (SIM) Grants 38 states & $1 billion in federal funds to develop & test innovative payment and service delivery models in public programs for use in statewide multi-payer programs with aligned measure sets. IOM Committee on Core Metrics for Better Health at Lower Costs Report originally due in fall, 2014 Now expected late February Commercial Measures Alignment Project AHIP initiative, staffed by NQF, to align measures with CMS Report originally expected in fall, 2014 8

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Presenters 9 Michael Bailit President Bailit Health mbailit@bailit-health.com Christine Hughes Senior Consultant Bailit Health chughes@bailit-health.com

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How to Build a Measure Set 10

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2015 Buying Value Measure Set Updates Updates to the following federal measure sets: January 2015: Core Set of Childrens Health Care Quality Measures for Medicaid and CHIP (Child Core Set) Core Set of Health Care Quality Measures for Adults Enrolled in Medicaid (Medicaid Adult Core Set) Physician Quality Reporting System (PQRS) for 2015 (entire list) EP EHR Incentive Clinical Quality Measures (eCQMs)(for 2015) Cross-cutting Measures November 2014: CMS Medicare Shared Savings Program (MSSP) ACO for 2015 CMS Medicare Part C & D Star Ratings Measures Addition of multi-stakeholder aligned measure sets from Maine and Washington 14

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Demonstration of the Measure Selection Tool 15

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Selected Organizations That Have Used the Measure Select Tool Maine Health Management Coalition Vermont Green Mountain Care Board Washington Health Alliance 16

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Experience with the Buying Value Measure Selection Tool Susan Schow, Maine Health Management Coalition 17

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Use of the Buying Value Tool in Maine Susan Schow, MPH, Healthcare Measurement Analyst

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Maine Health Management Coalition | Maine Health Management Coalition-Foundation 11 Bowdoin Mill Island, Suite 260 | Topsham, ME 04086 | (207) 899-1971 | www.mehmc.org | www.getbettermaine.org MHMCs Measure Alignment Efforts Accountable Care Implementation Committees Work Group Established Align measures used for Accountable Care Organization (ACO) payment and contracting Develop multi-payer measure set aligned closely with CMS ACO measures supplemented with pediatric and womens health metrics To minimize reporting burden, initial phase will rely on claims-based measures and available uniform survey results Identify outcomes measures for adoption as reporting capabilities grow Establish protocol for identification of pending measures (outcomes, functional status, etc.)

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Maine Health Management Coalition | Maine Health Management Coalition-Foundation 11 Bowdoin Mill Island, Suite 260 | Topsham, ME 04086 | (207) 899-1971 | www.mehmc.org | www.getbettermaine.org Maines Measure Alignment WG Identified Ten Criteria for Measure Inclusion: Current Feasibility Evidence-based and Scientifically Acceptable Setting Free Usability / Adaptability Patient Experience Has a Relevant Benchmark Financial / Incentivization Improving this Measure will Translate into Significant Changes in Value Durability Aligned with Other Measure Sets

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Maine Health Management Coalition | Maine Health Management Coalition-Foundation 11 Bowdoin Mill Island, Suite 260 | Topsham, ME 04086 | (207) 899-1971 | www.mehmc.org | www.getbettermaine.org Maines Measure Alignment WG How to evaluate or score each measure with so many different criteria? Buying Value Tool allowed scoring each measure as to how well it meets each criteria: Yes = 2 points Somewhat = 1 point No = 0 points Summed points for each measure Used tally to guide final review of draft measures for inclusion Allows for adding comments to record decisions Made complex task easy and documentable

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Maine Health Management Coalition | Maine Health Management Coalition-Foundation 11 Bowdoin Mill Island, Suite 260 | Topsham, ME 04086 | (207) 899-1971 | www.mehmc.org | www.getbettermaine.org Maines Measure Alignment WG Aligning with Other Measure Sets To shorten the list being considered, needed to identify measures most commonly used Many measures are similar but slightly different (e.g., Optimal Diabetes Care and Comprehensive Diabetes Care) Tool includes multiple federal measure set lists Allows inclusion of relevant local commercial and state measure sets Tool counts the highest overlap of reporting for identifying opportunities for alignment

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Q&A Roll over the green bar at the top of the page and left click on Q&A or Chat. Type your question in the box. Click on All Panelists in the Ask box. 23

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For More Information and a Helpful Resource Buying Value www.BuyingValue.org www.BuyingValue.org Bailit-authored brief titled Considerations for State Development of Performance Measure Sets www.rwjf.org/en/research-publications/find-rwjf- research/2014/09/considerations-for-state- development-of-performance-measure-sets.html www.rwjf.org/en/research-publications/find-rwjf- research/2014/09/considerations-for-state- development-of-performance-measure-sets.html 24