cms introduction to measures management.pptx
TRANSCRIPT
-
8/20/2019 CMS Introduction to Measures Management.pptx
1/27
CMS Measures Management SystemTraining Course
CMS Measures Management SystemTraining Course
Introduction toCMS MeasuresManagement
-
8/20/2019 CMS Introduction to Measures Management.pptx
2/27
• CMS Contracting Ofcer Representatives (CORs)who are managing measure contracts
• Measure Developers and Associations
• Individuals and Associations who are interested inthe Qualit Measures and the MeasureManagement Sstem! and who have a "asicunderstanding o# the purpose o# the $ualit%"ased
healthcare• Sponsoring Organi&ation' CMS Qualit
Measurement and alue%ased Incentives *roup(QMI*)
Intended Audience andCourse Structure
Intended Audience andCourse Structure
-
8/20/2019 CMS Introduction to Measures Management.pptx
3/27
• +ighlight ,e processes and re#erences #romthe MMS lueprint and COR +and"oo,
• Descri"e measure development!implementation! and maintenance processes
• Descri"e the overall responsi"ilities andtas,s o# the COR and the Measures
Management Support Contractor• Identi# measure developer contract
delivera"les and when the are due
Learning Objectives for theCourse Series
Learning Objectives for theCourse Series
-
8/20/2019 CMS Introduction to Measures Management.pptx
4/27
• Introduction to CMS MeasuresManagement (-his Course)
•
Measure Conceptuali&ation (.osting Soon/)• Measure Speci0cation (March 1234)
• Measure -esting (5une 1234)
• Measure Implementation (-A)
• Measure 6se! Continuing 7valuation! andMaintenance (-A)
Other Course Sessions
Other Course Sessions
-
8/20/2019 CMS Introduction to Measures Management.pptx
5/27
• 8hat are CMS Qualit Measures9
• 8hat CMS is currentl doing on +ealthcare QualitMeasures9
• 8hat is the CMS Measures Management Sstem(MMS) and how is the MMS documented9
• 8hat are the "asic steps in measure development!implementation! and maintenance9
• 8hat are the overall roles and responsi"ilities o#the Measures Manager! contractor! and COR9
• +ow can the Measures Manager help9
Introduction to CMSMeasure Management
Introduction to CMSMeasure Management
-
8/20/2019 CMS Introduction to Measures Management.pptx
6/27
:Qualit measures are tools that help usmeasure or $uanti# healthcare processes!outcomes! patient perceptions! andorgani&ational structure and;or sstems thatare associated with the a"ilit to providehigh%$ualit health care and;or that relate toone or more $ualit goals #or health care< -hese goals include' e=ective! sa#e! efcient!patient%centered! e$uita"le! and timel carehttp';;www
-
8/20/2019 CMS Introduction to Measures Management.pptx
7/27
@
Source' 1231 (rev 123) Annual .rogress Report to Congress! Bational Strateg #or QualitImprovement in +ealth Care! Su"mitted " the 6
-
8/20/2019 CMS Introduction to Measures Management.pptx
8/27
Source' 1231 (rev 123) Annual .rogress Report to Congress! BationalStrateg #or Qualit Improvement in +ealth Care! .age 3
• Ma,ing care sa#er " reducing harm caused inthe deliver o# care
• 7nsuring that each person and his or her #amilmem"ers are engaged as partners in their care
• .romoting e=ective communication and
coordination o# care• .romoting the most e=ective prevention and
treatment practices #or the leading causes o#mortalit! starting with cardiovascular disease<
• 8or,ing with communities to promote wide useo# "est practices to ena"le health living<
• Ma,ing $ualit care more a=orda"le #orindividuals! #amilies! emploers! andgovernment " developing and spreading newhealthcare deliver models<
$riorities of QualityStrategy
$riorities of QualityStrategy
-
8/20/2019 CMS Introduction to Measures Management.pptx
9/27
http';;socialhealthinsights
-
8/20/2019 CMS Introduction to Measures Management.pptx
10/27
• 7vidence%"ased approach toimproving health $ualit
•Monitor health outcomes as relatedto how care is delivered
• Assure accounta"ilit that $ualit
initiatives are implemented• -ransparenc G pu"lic reporting o#
$ualit
Why MeasureWhy Measure
32
-
8/20/2019 CMS Introduction to Measures Management.pptx
11/27
33
Ty"ical Ste"s in Measure'evelo"ment
Ty"ical Ste"s in Measure'evelo"ment
-
8/20/2019 CMS Introduction to Measures Management.pptx
12/27
• CMS H2 vE Closing the re#erral loop' receipt o# specialistreport
• .ercentage o# patients with re#errals! regardless o# age!#or which the re#erring provider receives a report #rom
the provider to whom the patient was re#erred<• 7?pressed as a numerator and denominator with
e?clusion statements – Initial $atient $o"ulation( Number of patients, regardless of
age, who were referred by one provider to another provider,
and who had a visit during the measurement period. – 'enominator( Equals Initial Patient Population;
• 7?clusions' Bone
– !umerator( Number of patients with a referral, for which thereferring provider received a report from the provider to whom
the patient was referred;• 7?clusions' Bot Applica"le
CMS Quality Measure)*am"le
CMS Quality Measure)*am"le
31
-
8/20/2019 CMS Introduction to Measures Management.pptx
13/27
Bumerous inputs are considered at all phases o#measure management'
• Claims
• Assessment instruments;8e" #orms
• Registries
• Chart a"straction or electronic health records
•
+"rid
'ata Sources'ata Sources
3E
-
8/20/2019 CMS Introduction to Measures Management.pptx
14/27
• :An eMeasure (also called eCQM) is ahealth $ualit measure encoded in a
+ealth Qualit Measures Format(+QMF)< eMeasures pull thein#ormation needed #rom electronic+ealth Records (e+Rs) to evaluateper#ormance
Bational Qualit Forum< .hrase"oo,' A .lain anguage *uide to BQF 5argon< 8ashington! DC'http';;pu"lic
-
8/20/2019 CMS Introduction to Measures Management.pptx
15/27
3H
All Qualit Measures have similarcomponents! "ut the data #orelectronic $ualit measures arediscretel managed in prescri"ed
#ormats on computer sstems< -hesame data can "e used #orreporting! transmitting to othercomputer sstems! and presentationin a human reada"le #ormat<
eCQM Com"onentseCQM Com"onents
-
8/20/2019 CMS Introduction to Measures Management.pptx
16/27
34
• Bational Qualit Forum (BQF) endorsement :relieson a set o# rigorous criteria to ensure that measuresunder consideration address aspects o# care that areimportant and #easi"le to measure! provide
consistent and credi"le in#ormation! and can "eused #or $ualit improvement and decision%ma,ing>
• BQF endorses measures that meet the #ollowingcriteria' –
Importance to measure and report – Scienti0c accepta"ilit o# the measure properties
– Feasi"ilit
– 6sa"ilit and usehttp';;www
-
8/20/2019 CMS Introduction to Measures Management.pptx
17/27
-he MMS is a set o# standardi&ed processesand decision criteria that guide contractedmeasure developers inK :developing!
implementing! and maintaining $ualitmeasures< -he primar goal o# the MeasuresManagement Sstem is to providein#ormation to measure developers to helpthem produce high%cali"er $ualit measuresthat are appropriate #or accounta"ilit>lueprint page 3
a s e easuresManagement System
,MMS-
Management System
,MMS-
3@
-
8/20/2019 CMS Introduction to Measures Management.pptx
18/27
• CMS manages activities such as measuredevelopment! maintenance! implementation! andpu"lic reporting< in,ed to MIDS 6m"rella<
•COR tas,ed with overseeing the measurescontract<
• Measure Contractors contracted " CMS to developand implement $ualit measurement programs<
•
Measures Manager supports the CMS COR andtheir various contractors in their wor,implementing the MMS<
%ey MMS $layers%ey MMS $layers
3
-
8/20/2019 CMS Introduction to Measures Management.pptx
19/27
3
isit https';;www
-
8/20/2019 CMS Introduction to Measures Management.pptx
20/27
• .rovide In#ormation and -raining Sessions
• .rovide technical assistance (in$uiries and re#errals)
• Continuousl improve the lueprint
• Develop tools to improve the storage and retrieval o# CMS
measure in#ormation
• Assist with +armoni&ation (ma,ing related measures uni#orm orcompati"le)
• Support CMS planning
• .rovide crosscutting perspective
• In#orm a"out new developments (e
-
8/20/2019 CMS Introduction to Measures Management.pptx
21/27
13
• Developer Support
• .rogram Integration
• Measures Inventor 6pdates• M6C ist Input
• Ad +oc Activities
• .rocess;Qualit Improvement• Resource contact'
MMSsupportLattelle
-
8/20/2019 CMS Introduction to Measures Management.pptx
22/27
• Follow the processes in the lueprint
• eep Measures Manager in the loop #ortechnical support development progresses
• Su"mit delivera"les to Measures Manageraccording to contractual re$uirements
• Consult with COR i# lueprint processes do
not meet contract needs• Meet with COR and Measures Manager a#ter
BQF su"mission to identi# lessons learned
Contractor/'evelo"er0s .oleContractor/'evelo"er0s .ole
11
-
8/20/2019 CMS Introduction to Measures Management.pptx
23/27
• 6nderstand the lueprint
• 6se the lueprint and +and"oo, as guides
• Boti# the Measures Manager when contractsare awarded
• 7nsure contractor compliance with thelueprint
•
Determine i# and when variation is appropriate• Approve delivera"les that are su"mitted
• Contact Measures Manager #or $uestions
CO.0s .oleCO.0s .ole
1E
-
8/20/2019 CMS Introduction to Measures Management.pptx
24/27
• *ain an understanding o# themeasure development li#eccle
•
7ngage with #eed"ac, on themeasure development process
• 6tili&e opportunities #or input
.ole of Individuals andAssociations
.ole of Individuals andAssociations
1
l i i
-
8/20/2019 CMS Introduction to Measures Management.pptx
25/27
1H
• Course designed to assist Developers;CORs " providing ,nowledge a"outthe measures development process
•
Qualit measures are tools thatena"le us to measure the per#ormanceo# the healthcare sstem
• -he Measures Management Sstem as documented inthe lueprint is a :set o# standardi&ed processes and
decision criteria that guide contracted measuredevelopers in developing! implementing! andmaintaining $ualit measures><
• -he COR wor,s with the Measures Manager to
oversee;support the wor, o# the Measures Contractors
1lue"rint 232 Session 2Summary
1lue"rint 232 Session 2Summary
i f 3 S i
-
8/20/2019 CMS Introduction to Measures Management.pptx
26/27
• 8hat is the Now o# the Measurei#eccle9
• 8hat are the components o# MeasureConceptuali&ation9
• 8hat is the role o# the COR
throughout MeasureConceptuali&ation phase9
$revie4 of 1$232 Session5( Conce"tuali6ation
$revie4 of 1$232 Session5( Conce"tuali6ation
14
-
8/20/2019 CMS Introduction to Measures Management.pptx
27/27
MMS Su""ort ContactMMS Su""ort Contact
Primary Support e-mail:
mailto:[email protected]:[email protected]:[email protected]:[email protected]