The National Committee of Quality Assurance has issued a series of recommendations urging President Joe Biden to take steps to evolve the current quality measurement ecosystem.  

"Though NCQA is a non-partisan organization, we believe that the new administration has a distinct opportunity to make revolutionary change – revolutionary improvements – to how care is delivered and how performance is measured," said NCQA director of communications Matt Brock in a blog post accompanying the recommendations.   

The recommendations focus on a number of key themes, including:

• Developing quality measurement to help stakeholders aim for health equity.
• Moving to a digital quality measurement system that provides results and decision support more quickly.
• Validating data to ensure accurate payments in value-based models.

"This digital quality future requires a lot more than [simply] digital measures or the standards that are evolving," said Brad Ryan, NCQA's chief product officer, in an interview with Healthcare IT News. "It requires the implementation of those standards and making those real."  

Four key objectives

The NCQA divided its recommendations into four key objectives:

• enabling a digital quality system.
• advancing health equity.
• digital patient-experience measurement.
• strengthening Medicare value-based programs.  

The committee noted that quality measurement has driven improvements in healthcare over the last three decades, with the Healthcare Effectiveness Data and Information Set, or HEDIS, giving industry leaders the ability to identify areas for improvement and to standardize expectations for high quality care.

However, it says, the United States needs a unified and timely quality measurement and reporting system – noting that the current model is largely retrospective, as well as fragmented and inconsistent.   

"On the big picture side, we've been talking with the Office of the National Coordinator for Health IT and the U.S. Department of Health and Human Services for more than a year about moving to digital measures and all the advantages inherent in that," said NCQA VP of public policy and communications Frank Micciche.   

Micciche explained that in early 2020, the Centers for Medicare and Medicaid Services announced a requirement for all quality measures to be reported digitally by 2030. 

That timeline, he said, "was longer than we would suggest, but just the fact that she put that flag in the ground was encouraging."  When it comes to patient experience measurement, NCQA also notes that the Consumer Assessment of Healthcare Providers and Systems surveys have failed to keep pace with changes in the healthcare industry.

CAHPS' shortcomings, it argues, include relying on paper-based mail or telephone and failing to identify the concerns of specific patient groups, such as people of color or patients with specific chronic illnesses.  

"In 2021, NCQA is planning to convene an expert panel of stakeholders from across the healthcare landscape to inform the plan for a bold, digitally-based reimagining of patient experience measurement. We would, of course, welcome the support and participation of the Biden administration in this effort," wrote the committee in its recommendations.

When it comes to the future, NCQA says the possibilities for next steps are varied, including the potential for public-private partnerships.

"NCQA has already started having convos with stakeholders … about the benefits of alignment and collaboration on some of this stuff. We feel like there's some critical mass there. We have put in front of CMS a couple of options for ways to fund real-world proof-of-concept projects," Ryan said.

"When it comes down to it we're talking about trying to facilitate transactions between many-to-many organizations," Ryan continued. "There is the complexity right there. There are models for doing this where you rely just on standards. There are other models where this evolves like clearinghouses. There's different ways to slice that."

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.