CMS Introduction to Measures Management.pptx

8/20/2019 CMS Introduction to Measures Management.pptx

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CMS Measures Management SystemTraining Course

CMS Measures Management SystemTraining Course

Introduction toCMS MeasuresManagement


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• 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


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• +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


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• 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


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• 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


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: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


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@

Source' 1231 (rev 123) Annual .rogress Report to Congress! Bational Strateg #or QualitImprovement in +ealth Care! Su"mitted " the 6


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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


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http';;socialhealthinsights


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• 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

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33

Ty"ical Ste"s in Measure'evelo"ment

Ty"ical Ste"s in Measure'evelo"ment


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• 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

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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


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• :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


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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


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• 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


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-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@


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• 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


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3

isit https';;www


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• .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


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• Developer Support

• .rogram Integration

• Measures Inventor 6pdates• M6C ist Input

• Ad +oc Activities

• .rocess;Qualit Improvement• Resource contact'

MMSsupportLattelle


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• 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

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• 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


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• *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


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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


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• 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

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MMS Su""ort ContactMMS Su""ort Contact

Primary Support e-mail:

[email protected]
mailto:[email protected]:[email protected]:[email protected]:[email protected]

CMS Introduction to Measures Management.pptx

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