From the desk of Cristie Upshaw Travis, CEO, Memphis Business Group on Health
As announced in early December 2016, I am honored to have been elected to the Board of Directors of the National Quality Forum (NQF).
Do you know how much the work of NQF matters in Memphis? For example:
- Today, over 300 NQF-endorsed measures are used in more than 20 federal programs. These measures and programs help determine the care that Memphis-area Medicare participants receive and how and how much our Memphis hospitals and physicians get paid by Medicare.
- Regional health plans in Tennessee, such as BlueCross BlueShield of Tennessee and Cigna, tend to follow Medicare's lead in both coverage and payment approaches.
- The measures used in the Hospital Safety Grade and Leapfrog Hospital Survey for Memphis-area hospitals are NQF-endorsed.
- Tennessee health plans use NQF-endorsed measures to evaluate the quality of their networks and in their new payment models.
And, because of NQF, we can compare the quality and cost of care we have here in Memphis to other communities across the country since each community is using the same measures and data to evaluate care. Through the NQF we have standardized our measures so we can track our own improvements over time and identify best practices both within Memphis and elsewhere to rapidly advance care delivery.
Since 1997, MBGH has focused on working toward and advancing value-based purchasing in the greater-Memphis market. We defined value-based purchasing as a function of health status/outcomes, patient experience, and cost. Right away we were challenged with the fact that although employers knew their costs, but they had no idea what they were getting in terms of the health status/outcomes for their employees or the experience their employees were having as they navigated the healthcare delivery system.
We were not alone in lacking this information and understanding. The nation as a whole only had crude ways of evaluating the quality and experience of care using such measures as mortality, length of stay, and cost per stay/day in the hospital. Unfortunately, these early measures didn’t really help us understand the underlying issues that were driving these results, nor did they provide information upon which we could make purchasing decisions or help employees select providers.
Fast forward 20 years later to 2017 and we are now operating in a very different world. In fact, there are many who say we have too much information now! So, how do we decide what measures to use and when to use them?
The National Quality Forum (NQF) was established to help us answer these questions. Through it’s measure endorsement process, NQF:
Calls for measures that matter for health/well-being; prevention/treatment of leading causes of mortality; person and family-centered care; effective communication and care coordination; patient safety; and affordable care.
Conducts detailed reviews of proposed measures through standing committees to ensure they reflect sound science, will be useful to providers and patients, and will make a difference in improving quality.
Seeks public comment and input from any interested party during the decision-making process.
Provides oversight of committee decisions through the Consensus Standards Approval Committee which helps ensure consistency across standing committees and alignment with overall NQF goals.
Includes an appeals process through an Appeals Board.
I have always thought it was important to be actively involved in national policies that have such a significant impact on the Memphis community. After all, if we don’t get involved, we may find that the measures and the quality and cost that they drive are not in our best interest. I am often the only Southerner on a committee; I am often one of only a few employer/purchaser representatives on a committee; I am often one of only a few market-focused (vs. nationally or institutionally-focused) representatives on a committee. All of these voices need to be heard during the decision-making process. And, because I am involved, I have a much deeper understanding for these measures that are critical to the quality, cost, and payment right here in Memphis.
Please let me know if you have any questions about NQF. I am also available to speak with you and your senior leadership about NQF and the role it plays in measurement and federal programs. The more we understand and the more active we are, the better this process will be for us in Memphis.