Vital Signs Core Metrics for Health and Health Care Progress (2015) / Chapter Skim
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Appendix B: Existing Reporting Requirements
Appendix B: Existing Reporting Requirements
Pages 231-246
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Although collected locally, the data are compiled nationally through a cooperative agreement with the National Center for Health Statistics in the Centers for Disease Control and Prevention (CDC)
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The measures address primarily ambulatory, inpatient, and home care, although measures exist for many other care settings (see Table B-3)
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Hepatitis B, perinatal infection Trichinellosis Hepatitis C, acute Tuberculosis Hepatitis C, past or present Tularemia HIV infection (AIDS has been Typhoid fever reclassified as HIV Stage III) Vancomycin-intermediate Influenza-associated pediatric staphylococcus aureus mortality and vancomycin-resistant Invasive pneumococcal disease staphylococcus aureus Legionellosis Varicella Listeriosis Varicella deaths Lyme disease Vibriosis Malaria Viral hemorrhagic fever Measles Yellow fever Meningococcal disease Mumps
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TABLE B-2 Focus of Measures Employed by the Centers for Medicare & Medicaid Services for Reporting Purposes Measure Focus Number of Measures Access 21 Efficiency 12 Outcome 222 Patient experience 41 Process 580 Structure 25 Other 12 SOURCE: U.S. Department of Health and Human Services Measure Inventory, 2013.
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TABLE B-4 Selected Topics or Conditions for Reported Measures Employed by the Centers for Medicare & Medicaid Services Condition/Topic Number of Measures Cancer 45 Cardiovascular and stroke 137 Central nervous system (dementia, Parkinson's, epilepsy) 19 Chronic and elder care 57 Communicable diseases (immunizations, methicillin-resistant 53 staphylococcus aureus [MRSA]
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From page 236... ...
, while the managed care and home- and community-based services waivers focus on specific populations and services. States can use research and demonstration waivers for testing new approaches, including expansion of coverage to individuals not otherwise eligible for Medicaid or CHIP, provision of coverage for services not typically covered by the program, or the application of delivery system innovations to improve the quality and value of care (Alker and Artiga, 2012; Artiga, 2011)
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. Table B-6 illustrates the care settings assessed by different payment models, demonstrating that some models are focused exclusively on one care setting, such as inpatient care, while others consider outcomes from all settings.
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TABLE B-5 Reporting Requirements for Different Payment Models by Measure Focus 238 Payment Reform Models Global Payment ACO Shared Saving Program Medical Home Bundled Payment Hospital-Physician Gain-sharing Payment for Coordination Hospital P4P Payment Adjustment for Readmissions Payment Adjustment for Hospital Acquired Conditions Physician P4P Payment for Shared Decision Making Measurement Domain Outcome Mortality Health Morbidity status Functional status Health-related QoL Safety Outcomes Patient experience/satisfaction Other outcome Process Population Preventive services health Healthy behaviors Clinical care Care coordination Patient/family/ caregiver engagement Safety practices Other process
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Dark shading: specific measures or measure sets fit within this domain, or program documentation names a specific measurement algorithm. ACO = accountable care organization; ER/ED = emergency room/emergency department; HIT = health information technology; LOS = length of stay; P4P = pay for performance; QoL = quality of life.
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facility Clinician office Hospital/ Inpatient Measurement Domain acute care Outpatient ASC Clinic ER/ED Imaging Surgery/ Laboratory Other outpatient Global Payment ACO Shared Saving Program Medical Home Payment Reform Models Bundled Payment Hospital-Physician Gain-sharing Payment for Coordination Hospital P4P Payment Adjustment TABLE B-6 Reporting Requirements for Payment Models Organized by Their Care Setting for Readmissions Payment Adjustment for Hospital-Acquired Conditions Physician P4P Payment for Shared Decision Making 240
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ACO = accountable care organization; ASC = ambulatory surgery center; ER/ED = emergency room/emergency department; HIT = health information technology; LTC = long-term care; P4P = pay for performance; SNF = skilled nursing facility. SOURCE: Schneider et al., 2011.
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. The Joint Commission accredits approximately 20,000 health care organizations and programs, while NCQA accredits health plans and offers voluntary programs for new care delivery models (Berenson et al., 2013)
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TABLE B-8 Number of Publicly Reported Measures by Setting or Organization Assessed Number of Publicly Element of the Health System Reported Measures Ambulatory/office-based care 159 Ancillary services 16 Assisted living facilities 0 Behavioral health care 10 Community health care 20 Emergency medical services 11 Emergency room 9 Home care 21 Hospices 9 Hospital inpatient 89 Hospital outpatient 14 Intensive care units 4 Managed care plans 88 Rehabilitation centers 11 Residential care facilities 12 Rural health care 10 Skilled nursing facilities 15 Substance use treatment programs/centers 1 Transition 16 SOURCE: Analysis of National Quality Measures Clearinghouse data. Accessed May 31, 2013.
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2012a. Integrating clinical practice and public health surveillance us ing electronic medical record systems.
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2012. Few adverse events in hospitals were reported to state adverse event reporting systems.
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