Vital Signs Core Metrics for Health and Health Care Progress (2015) / Chapter Skim
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6 Action Agenda
6 Action Agenda
Pages 213-226
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From page 213... ...
Each sector faces different measurement challenges, has different roles and opportunities, is accountable for different aspects of the system's progress, and depends on critical preconditions for success. FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS Based on the findings and conclusions identified throughout the preceding chapters, the Committee recommends the rapid and effective adoption and implementation of the core measures for better health at lower cost identified in this report (see Figure 6-1)
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214 VITAL SIGNS Life e expectancy WELL-BEING Well-being Overweight and obesity Addictive behavior Unintended pregnancy Healthy communities Preventive services Care access Patient safety Evidence-based care Care match with patient goals Personal spending burden Population spending burden Individual engagement Community engagement FIGURE 6-1 The core measure set. FI GURE 6-1 The core m easure set.
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Department of Health and Human Services (HHS) should use the core measure set to sharpen the focus and consis tency and reduce the number and the burden of measure reporting requirements in the programs administered throughout HHS, as well as throughout the nation.
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, to ensure that the core measure set becomes a central element of every electronic health record; • MS's accountable care organization measurement and reporting C requirements; • MS's strategies for promoting quality improvement and innovation in C health care financing and delivery through the work of the Center for Medi care & Medicaid Innovation; • ederal health care reporting requirements; f • treamlined reporting requirements under state Medicaid waiver authority; s and • categorical health grant program management. Recommendation 4: With the engagement and involvement of the Executive Office of the President, the Secretary of HHS should develop and implement a strategy for working with other federal and state agencies and national organiza tions to facilitate the use and application of the core measure set.
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Clinicians and Health Care Delivery Organizations Recommendation 7: Clinicians and the health care organizations in which they work should routinely assess their contributions to performance on the core mea sures and identify opportunities to work collaboratively with community and public health stakeholders to realize improvements in population health. Employers and Other Community Leaders Recommendation 8: Employers and other community leaders should use the core measures to shape, guide, and assess their incentive programs, their pur chasing decisions, and their own health care interventions, including initiatives aimed at achieving transparency in health costs and outcomes and at fostering seamless interfaces between clinical care and supportive community resources.
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From page 218... ...
In turn, this inefficiency may lead to unnecessary burdens when the collection and management of redundant measures imposes associated costs that outweigh the benefits, as well as to lost opportunities when the data collected are neither working synergistically with those collected in other programs nor directed optimally toward the development of new knowledge. Conclusions: Use of a core measure set throughout all federal health programs could help better orient those programs while expanding the reach of their contributions.
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From page 219... ...
and the Office of the Na tional Coordinator (ONC) , to ensure that the core measure set becomes a central element of every electronic health record; • MS's accountable care organization measurement and reporting C requirements; • MS's strategies for promoting quality improvement and innova C tion in health care financing and delivery through the work of the Center for Medicare & Medicaid Innovation; • federal health care reporting requirements; • treamlined reporting requirements under state Medicaid waiver s authority; and • categorical health grant program management.
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From page 220... ...
Department of Health and Human Services should establish and implement a mechanism for involving multiple expert stakeholder organizations in efforts to develop as necessary, maintain, and improve each of the core measures and the core measure set as a whole over time. The Secretary's role should encompass stewardship of work on • ational standardization of the best current measures and related n priority measures detailed in this report; • evelopment of the longer-term indicators necessary to improve the d utility and generalizability of the core measures; • ational standardization of reporting on health disparities for each n of the core measures, including disparities based on race, ethnicity, gender, and socioeconomic status;
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From page 221... ...
Recommendation 6: Governors, mayors, and state and local health leaders should use the core measure set to develop tailored dashboards and drive a focus on outcomes in the programs administered in their jurisdictions, and they should enlist leaders from other sectors in these efforts.
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Conclusions: The active participation of clinicians and health care organizations is essential to remedy this situation and achieve the potential of a core measure set. Clinicians and health care organizations need to recognize the role of the core measures in improving care for individual patients and the health care enterprise.
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Recommendation 9: Payers and purchasers of health care should use the core measures to capture data that can be used for accountability for results that matter most to personal and population health, to refine the analytics involved, and to make databases of the measures available for continuous improvement. Standards Organizations Findings: The proliferation of measures and reporting requirements is due in part to the expansion of measure development and implementation by standards organizations that encourage or require providers to report on performance for accreditation purposes.
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From page 224... ...
Leadership in the implementation of the core measure set also is required at other levels of the health system, including the community, county, and state levels, as well as from leadership within health stakeholder groups. For example, strong leadership on health at the corporate CEO level could orient care purchasing and planning decisions within a large company around the core measures so that meaningful comparisons could be made among care options, and health initiatives and policies could be focused on particular priorities or challenges in the health outcomes of the employee population.
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From page 225... ...
While the core measures themselves present a standard approach to measuring priority outcomes, achieving the required level of data reporting and use will present different challenges for different groups. A thoughtful planning process with broad input from relevant parties could aid in supporting successful implementation by ensuring that responsibilities, challenges, and gaps are addressed early and that potential barriers to successful implementation are identified.
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From page 226... ...
While progress is being made across the country in the development and use of digital infrastructure components such as electronic health records, the nationwide health data infrastructure is characterized by numerous different systems with limited interoperability, disparate levels of use, and approaches to use based on local factors and needs. While in the short term, core measures at different levels may be assembled from unconnected data systems and with varying levels of detail and coverage, in the long term, core measures could drive progress in infrastructure development and interoperability around those measures that are of the highest priority for understanding and measuring progress in the health system.
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