NQF Opens Comment Period on Federal Program Quality Measures

The National Quality Forum (NQF) has launched a comment period related to quality measures in federal programs.

“Conducting a thoughtful review of performance measures used in federal programs is an essential discipline to continuously improving the quality, safety and outcomes of care experienced across the nation,” Dana Gelb Safran, president and chief executive officer at NQF, said in the press release. 

“Using MAP’s multistakeholder consensus process to recommend both the addition and removal of measures promotes parsimony and impact across federal performance improvement programs.” 

There are a total of 32 quality measures that have been submitted for consideration. Each of the quality measures is related to one of six federal programs that require quality oversight. 

The six programs are the Home Health Quality Reporting program (HH QRP), the Merit-based Incentive Payment System (MIPS), the Medicare Shared Savings program (MSSP), Hospital Outpatient Quality Reporting program (Hospital OQR), the Ambulatory Surgical Center Quality Reporting (ASCQR) program, and the  PPS-Exempt Cancer Hospital Quality Reporting (PCHQR) program.

While the Hospice Quality Reporting program (HQRP) was listed, no quality measures for this program received enough votes to be placed under consideration.

HH QRP, MIPS, and MSSP had the highest number of quality measures that required comment.

“This public comment period provides an opportunity for stakeholders to weigh in on whether they think the measures that have been identified remain valuable to the programs they are in,” the press release explained. “While the focus of the effort is to facilitate measure removal, reduce burden, and improve focus on priority measures, it is also an opportunity for stakeholders to share their perspective on the importance of retaining measures in program(s).”

The Measure Set Review for 2022 followed a 2021 pilot that sought stakeholder insight from the Measure Applications Partnership (MAP), a public-private partnership that represents health plans, purchasers, patients, public health experts, and other stakeholders.

While quality measures that may require review were selected by CMS and NQF, MAP stakeholders voted on which quality measures they would prefer to remove. These actions represent the first half of a four-step process in which stakeholders consider a set of federal program quality measures for removal.

In the second half of the process, NQF publishes the results of the survey, sharing the quality measures that had the most votes for removal. 

As they consider the quality measures and submit their comments, NQF suggested that stakeholders contemplate whether each quality measure aligns with its federal program’s goals, demonstrates positive patient outcomes, is supported by up-to-date evidence, assigns a high reporting burden, or has unintended, negative outcomes.

After the seven-day comment period, the last step of the process will involve a discussion between stakeholders from the MAP Advisory Groups, NQF workgroups, and the coordinating committee.

At the end of the discussion process, members will vote to voice their support for retaining, conditional support for retaining, conditional support for removal, or support for removal of each quality measure.

“We are excited to build on the insights from the 2021 pilot as we continue to partner with CMS on expanding this novel component of the work,” Safran added.

The comment period will end May 25, 2021 at 6pm ET.

Quality measures are an important part of the US healthcare system. Each year, stakeholders across the industry reassess whether the quality measures that appraise their efforts are still true to the healthcare system’s goals and orientation.

During the height of the coronavirus pandemic, healthcare leaders called for a move to digital quality measures and others have noted the need for social risk to factor into quality measurement.