8
DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Improving Quality of Care for Medicare Patients: Accountable Care Organizations FACT SHEET http://www.cms.gov/sharedsavingsprogram Overview On October 20, 2011, the Centers for Medicare & Medicaid Services (CMS), an agency within the 'HSDUWPHQW RI +HDOWK +XPDQ 6HUYLFHV ++6 ¿QDOL]HG QHZ UXOHV XQGHU WKH $IIRUGDEOH &DUH $FW to help doctors, hospitals, and other health care providers better coordinate care for Medicare patients WKURXJK $FFRXQWDEOH &DUH 2UJDQL]DWLRQV $&2V $&2V FUHDWH LQFHQWLYHV IRU KHDOWK FDUH SURYLGHUV WR ZRUN WRJHWKHU WR WUHDW DQ LQGLYLGXDO SDWLHQW DFURVV FDUH VHWWLQJV ± LQFOXGLQJ GRFWRU¶V RI¿FHV KRVSLWDOV DQG ORQJWHUP FDUH IDFLOLWLHV 7KH 0HGLFDUH 6KDUHG 6DYLQJV 3URJUDP 6KDUHG 6DYLQJV 3URJUDP ZLOO UHZDUG $&2V WKDW ORZHU WKHLU JURZWK LQ KHDOWK FDUH FRVWV ZKLOH PHHWLQJ SHUIRUPDQFH VWDQGDUGV RQ TXDOLW\ RI FDUH DQG SXWWLQJ SDWLHQWV ¿UVW 3URYLGHU SDUWLFLSDWLRQ LQ DQ $&2 LV SXUHO\ YROXQWDU\ ,Q GHYHORSLQJ WKLV ¿QDO UXOH &06 ZRUNHG FORVHO\ ZLWK DJHQFLHV DFURVV WKH )HGHUDO JRYHUQPHQW WR ensure a coordinated and aligned inter- and intra-agency effort to facilitate implementation of the Shared 6DYLQJV 3URJUDP &06 HQFRXUDJHV DOO LQWHUHVWHG SURYLGHUV DQG VXSSOLHUV WR UHYLHZ WKLV ¿QDO UXOH DQG FRQVLGHU SDUWLFLSDWLQJ LQ WKH 6KDUHG 6DYLQJV 3URJUDP 7KLV IDFW VKHHW GHVFULEHV WKH TXDOLW\ PHDVXUHV DQG WKH PHWKRG IRU VFRULQJ DQ $&2¶V SHUIRUPDQFH IRU SXUSRVHV RI PHHWLQJ WKH TXDOLW\ SHUIRUPDQFH VWDQGDUG XQGHU WKH 6KDUHG 6DYLQJV 3URJUDP ACO Final Quality Measures and Performance Scoring Methodology Quality Measures: 7KH ¿QDO UXOH DGRSWV LQGLYLGXDO PHDVXUHV RI TXDOLW\ SHUIRUPDQFH WKDW ZLOO EH XVHG WR GHWHUPLQH LI DQ $&2 TXDOL¿HV IRU VKDUHG VDYLQJV 7KHVH PHDVXUHV VSDQ IRXU TXDOLW\ GRPDLQV 3DWLHQW ([SHULHQFH RI &DUH &DUH &RRUGLQDWLRQ3DWLHQW 6DIHW\ 3UHYHQWLYH +HDOWK DQG $W5LVN 3RSXODWLRQ 7KH OLVW RI PHDVXUHV LV LQFOXGHG DV DQ DSSHQGL[ WR WKLV IDFW VKHHW 1 ICN 907407 October 2011

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Page 1: Improving Quality of Care for Medicare Patients: …garnerhealth.com/.../2011/11/Improving-Quality-of-Care.pdfImproving Quality of Care for Medicare Patients: Accountable Care Organizations

DEPARTMENT OF HEALTH AND HUMAN SERVICESCenters for Medicare & Medicaid Services

Improving Quality of Care for Medicare Patients:

Accountable Care OrganizationsFACT SHEET http://www.cms.gov/sharedsavingsprogram

Overview

On October 20, 2011, the Centers for Medicare & Medicaid Services (CMS), an agency within the 'HSDUWPHQW�RI�+HDOWK��+XPDQ�6HUYLFHV��++6���¿QDOL]HG�QHZ�UXOHV�XQGHU�WKH�$IIRUGDEOH�&DUH�$FW�to help doctors, hospitals, and other health care providers better coordinate care for Medicare patients WKURXJK�$FFRXQWDEOH�&DUH�2UJDQL]DWLRQV��$&2V���$&2V�FUHDWH�LQFHQWLYHV�IRU�KHDOWK�FDUH�SURYLGHUV�WR�ZRUN�WRJHWKHU�WR�WUHDW�DQ�LQGLYLGXDO�SDWLHQW�DFURVV�FDUH�VHWWLQJV�±�LQFOXGLQJ�GRFWRU¶V�RI¿FHV��KRVSLWDOV��DQG�ORQJ�WHUP�FDUH�IDFLOLWLHV��7KH�0HGLFDUH�6KDUHG�6DYLQJV�3URJUDP��6KDUHG�6DYLQJV�3URJUDP��ZLOO�UHZDUG�$&2V�WKDW�ORZHU�WKHLU�JURZWK�LQ�KHDOWK�FDUH�FRVWV�ZKLOH�PHHWLQJ�SHUIRUPDQFH�VWDQGDUGV�RQ�TXDOLW\�RI�FDUH�DQG�SXWWLQJ�SDWLHQWV�¿UVW��3URYLGHU�SDUWLFLSDWLRQ�LQ�DQ�$&2�LV�SXUHO\�YROXQWDU\�

,Q�GHYHORSLQJ�WKLV�¿QDO�UXOH��&06�ZRUNHG�FORVHO\�ZLWK�DJHQFLHV�DFURVV�WKH�)HGHUDO�JRYHUQPHQW�WR�ensure a coordinated and aligned inter- and intra-agency effort to facilitate implementation of the Shared 6DYLQJV�3URJUDP�

&06�HQFRXUDJHV�DOO�LQWHUHVWHG�SURYLGHUV�DQG�VXSSOLHUV�WR�UHYLHZ�WKLV�¿QDO�UXOH�DQG�FRQVLGHU�SDUWLFLSDWLQJ�LQ�WKH�6KDUHG�6DYLQJV�3URJUDP�

7KLV�IDFW�VKHHW�GHVFULEHV�WKH�TXDOLW\�PHDVXUHV�DQG�WKH�PHWKRG�IRU�VFRULQJ�DQ�$&2¶V�SHUIRUPDQFH�IRU�SXUSRVHV�RI�PHHWLQJ�WKH�TXDOLW\�SHUIRUPDQFH�VWDQGDUG�XQGHU�WKH�6KDUHG�6DYLQJV�3URJUDP�

ACO Final Quality Measures and Performance Scoring Methodology

Quality Measures:�7KH�¿QDO�UXOH�DGRSWV����LQGLYLGXDO�PHDVXUHV�RI�TXDOLW\�SHUIRUPDQFH�WKDW�ZLOO�EH�XVHG�WR�GHWHUPLQH�LI�DQ�$&2�TXDOL¿HV�IRU�VKDUHG�VDYLQJV��7KHVH����PHDVXUHV�VSDQ�IRXU�TXDOLW\�GRPDLQV��3DWLHQW�([SHULHQFH�RI�&DUH��&DUH�&RRUGLQDWLRQ�3DWLHQW�6DIHW\��3UHYHQWLYH�+HDOWK��DQG�$W�5LVN�3RSXODWLRQ��7KH�OLVW�RI�PHDVXUHV�LV�LQFOXGHG�DV�DQ�DSSHQGL[�WR�WKLV�IDFW�VKHHW��

1

ICN 907407 October 2011

Page 2: Improving Quality of Care for Medicare Patients: …garnerhealth.com/.../2011/11/Improving-Quality-of-Care.pdfImproving Quality of Care for Medicare Patients: Accountable Care Organizations

Improving Quality of Care for Medicare Patients:

Accountable Care Organizations

7KH�$&2�TXDOLW\�PHDVXUHV�DOLJQ�ZLWK�WKRVH�XVHG�LQ�RWKHU�&06�TXDOLW\�SURJUDPV��VXFK�DV�WKH�3K\VLFLDQ�4XDOLW\�5HSRUWLQJ�6\VWHP�DQG�WKH�(OHFWURQLF�+HDOWK�5HFRUG�

�(+5��,QFHQWLYH�3URJUDPV��7KH�$&2�TXDOLW\�PHDVXUHV�DOVR�DOLJQ�ZLWK�WKH�1DWLRQDO�4XDOLW\�6WUDWHJ\�DQG�RWKHU�++6�SULRULWLHV��VXFK�DV�WKH�0LOOLRQ�+HDUWV�,QLWLDWLYH�

,Q�GHYHORSLQJ�WKH�¿QDO�UXOH��&06�OLVWHQHG�WR�LQGXVWU\�FRQFHUQV�DERXW�IRFXVLQJ�PRUH�on outcomes and considered a broad array of measures that would help to assess DQ�$&2¶V�VXFFHVV�LQ�GHOLYHULQJ�KLJK�TXDOLW\�KHDOWK�FDUH�DW�ERWK�WKH�LQGLYLGXDO�DQG�SRSXODWLRQ�OHYHOV��&06�DOVR�VRXJKW�WR�DGGUHVV�FRPPHQWV�WKDW�VXSSRUWHG�DGRSWLQJ�IHZHU�WRWDO�PHDVXUHV�WKDW�UHÀHFW�SURFHVVHV�DQG�RXWFRPHV��DQG�DOLJQLQJ�WKH�PHDVXUHV�ZLWK�WKRVH�XVHG�LQ�RWKHU�TXDOLW\�UHSRUWLQJ�SURJUDPV��VXFK�DV�WKH�3K\VLFLDQ�4XDOLW\�5HSRUWLQJ�6\VWHP�

Reporting:�7KH�PHDVXUHV�ZLOO�EH�UHSRUWHG�WKURXJK�D�FRPELQDWLRQ�RI�D�ZHE�LQWHUIDFH�GHVLJQHG�IRU�FOLQLFDO�TXDOLW\�PHDVXUH�UHSRUWLQJ�DQG�SDWLHQW�H[SHULHQFH�RI�FDUH�VXUYH\V��,Q�DGGLWLRQ��&06�FODLPV�DQG�DGPLQLVWUDWLYH�GDWD�ZLOO�EH�XVHG�WR�FDOFXODWH�RWKHU�PHDVXUHV�LQ�RUGHU�WR�UHGXFH�DGPLQLVWUDWLYH�EXUGHQ��&06�ZLOO�DOVR�DGPLQLVWHU�DQG�SD\�IRU�WKH�SDWLHQW�H[SHULHQFH�RI�FDUH�VXUYH\�IRU�WKH�¿UVW���\HDUV�RI�WKH�6KDUHG�6DYLQJV�3URJUDP�������DQG�������$&2V�ZLOO�EH�UHVSRQVLEOH�IRU�VHOHFWLQJ�DQG�SD\LQJ�IRU�D� &06�FHUWL¿HG�YHQGRU�WR�DGPLQLVWHU�WKH�SDWLHQW�VXUYH\�EHJLQQLQJ�LQ������

:KLOH�DQ�$&2¶V�¿UVW�SHUIRUPDQFH�\HDU�IRU�VKDUHG�VDYLQJV�SXUSRVHV�ZRXOG�EH����RU����PRQWKV��GHSHQGLQJ�RQ�WKH�VWDUW�GDWH��TXDOLW\�GDWD�ZLOO�EH�FROOHFWHG�RQ�D�FDOHQGDU�\HDU�EDVLV��EHJLQQLQJ�ZLWK�WKH�UHSRUWLQJ�SHULRG�HQGLQJ�'HFHPEHU����������

Quality Performance Scoring:�$V�UHTXLUHG�E\�WKH�$IIRUGDEOH�&DUH�$FW��EHIRUH�DQ�$&2�FDQ�VKDUH�LQ�DQ\�VDYLQJV�FUHDWHG��LW�PXVW�GHPRQVWUDWH�WKDW�LW�PHW�WKH�TXDOLW\�SHUIRUPDQFH�VWDQGDUG�IRU�WKDW�\HDU�

)RU�WKH�¿UVW�SHUIRUPDQFH�\HDU��&06�LV�GH¿QLQJ�WKH�TXDOLW\�SHUIRUPDQFH�VWDQGDUG�DW�WKH�OHYHO�RI�FRPSOHWH�DQG�DFFXUDWH�UHSRUWLQJ�IRU�DOO�TXDOLW\�PHDVXUHV��'XULQJ�VXEVHTXHQW�SHUIRUPDQFH�\HDUV��WKH�TXDOLW\�SHUIRUPDQFH�VWDQGDUG�ZLOO�EH�SKDVHG�LQ�VXFK�WKDW�$&2V�PXVW�FRQWLQXH�WR�UHSRUW�DOO�PHDVXUHV�EXW�ZLOO�HYHQWXDOO\�EH�DVVHVVHG�RQ�SHUIRUPDQFH�

3D\�IRU�SHUIRUPDQFH�ZLOO�EH�SKDVHG�LQ�RYHU�WKH�$&2¶V�¿UVW�DJUHHPHQW�SHULRG�DV�IROORZV�

�� <HDU����3D\�IRU�UHSRUWLQJ�DSSOLHV�WR�DOO����PHDVXUHV��� <HDU����3D\�IRU�SHUIRUPDQFH�DSSOLHV�WR����PHDVXUHV��3D\�IRU�UHSRUWLQJ�DSSOLHV�WR�HLJKW�PHDVXUHV��� <HDU����3D\�IRU�SHUIRUPDQFH�DSSOLHV�WR����PHDVXUHV��3D\�IRU�UHSRUWLQJ�DSSOLHV�WR�RQH�PHDVXUH�

WKDW�LV�D�VXUYH\�PHDVXUH�RI�IXQFWLRQDO�VWDWXV��&06�ZLOO�NHHS�WKH�PHDVXUH�LQ�SD\�IRU�UHSRUWLQJ�VWDWXV�IRU�WKH�HQWLUH�DJUHHPHQW�SHULRG��7KLV�ZLOO�DOORZ�$&2V�WR�JDLQ�H[SHULHQFH�ZLWK�WKH�measure and will provide important information to them on improving the outcomes of their SDWLHQW�SRSXODWLRQV�

&06�LQWHQGV�WR�HVWDEOLVK�QDWLRQDO�EHQFKPDUNV�IRU�$&2�TXDOLW\�PHDVXUHV�DQG�ZLOO�UHOHDVH�EHQFKPDUN�GDWD�DW�WKH�VWDUW�RI�WKH�VHFRQG�SHUIRUPDQFH�\HDU�ZKHQ�WKH�SD\�IRU�SHUIRUPDQFH�SKDVH�LQ�EHJLQV��)RU�SD\�IRU�SHUIRUPDQFH�PHDVXUHV��WKH�PLQLPXP�DWWDLQPHQW�OHYHO�ZLOO�EH�VHW�DW�D�QDWLRQDO����SHUFHQW�RU�WKH�QDWLRQDO���th�SHUFHQWLOH�RI�WKH�SHUIRUPDQFH�EHQFKPDUN��3HUIRUPDQFH�EHQFKPDUNV�ZLOO�EH�

2

Page 3: Improving Quality of Care for Medicare Patients: …garnerhealth.com/.../2011/11/Improving-Quality-of-Care.pdfImproving Quality of Care for Medicare Patients: Accountable Care Organizations

Improving Quality of Care for Medicare Patients:

Accountable Care Organizations

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))6�FODLPV�GDWD�LV�QRW�DYDLODEOH��3HUIRUPDQFH�HTXDO�WR�RU�JUHDWHU�WKDQ�WKH�PLQLPXP�DWWDLQPHQW�OHYHO�IRU�D�PHDVXUH�ZLOO�UHFHLYH�SRLQWV�RQ�D�VOLGLQJ�VFDOH�EDVHG�RQ�WKH�OHYHO�RI�SHUIRUPDQFH��3HUIRUPDQFH�DW�

or above 90 percent or the 90th�SHUFHQWLOH�RI�WKH�SHUIRUPDQFH�EHQFKPDUN�ZLOO�HDUQ�WKH�PD[LPXP�SRLQWV�DYDLODEOH�IRU�WKH�PHDVXUH�

7KH�GLDEHWHV�DQG�&RURQDU\�$UWHU\�'LVHDVH��&$'��FRPSRVLWH�PHDVXUHV�ZLOO�HDFK�UHFHLYH�WKH�PD[LPXP�DYDLODEOH�SRLQWV�LI�DOO�FULWHULD�DUH�PHW�DQG�]HUR�SRLQWV�LI�RQH�RU�PRUH�RI�WKH�FULWHULD�DUH�QRW�PHW��7KH�(+5�,QFHQWLYH�3URJUDPV�SDUWLFLSDWLRQ�PHDVXUH�ZLOO�EH�GRXEOH�ZHLJKWHG�LQ�RUGHU�WR�HQFRXUDJH�(+5�DGRSWLRQ�

CMS will add the points earned for the individual measures within each domain and divide by the total SRLQWV�DYDLODEOH�IRU�WKH�GRPDLQ�WR�GHWHUPLQH�HDFK�RI�WKH�IRXU�GRPDLQ�VFRUHV��7KH�GRPDLQV�ZLOO�EH�ZHLJKWHG�HTXDOO\�DQG�VFRUHV�DYHUDJHG�WR�GHWHUPLQH�WKH�$&2¶V�RYHUDOO�TXDOLW\�SHUIRUPDQFH�VFRUH�DQG�VKDULQJ�UDWH��$&2V�ZRXOG�QHHG�WR�DFKLHYH�WKH�PLQLPXP�DWWDLQPHQW�OHYHO�RQ�DW�OHDVW����SHUFHQW�RI�WKH�PHDVXUHV�LQ�HDFK�GRPDLQ�WR�DYRLG�EHLQJ�SODFHG�RQ�D�FRUUHFWLYH�DFWLRQ�SODQ�

,Q�DGGLWLRQ�WR�WKH�PHDVXUHV�XVHG�IRU�WKH�TXDOLW\�SHUIRUPDQFH�VWDQGDUGV�IRU�VKDUHG�VDYLQJV�HOLJLELOLW\��&06�ZLOO�DOVR�XVH�FHUWDLQ�PHDVXUHV�IRU�PRQLWRULQJ�SXUSRVHV��WR�HQVXUH�$&2V�DUH�QRW�DYRLGLQJ�DW�ULVN�SDWLHQWV�RU�HQJDJLQJ�LQ�RYHUXVH��XQGHUXVH��RU�PLVXVH�RI�KHDOWK�FDUH�VHUYLFHV�

Incorporation of the Physician Quality Reporting System into the Shared Savings Program:�7KH�$IIRUGDEOH�&DUH�$FW�DOORZV�&06�WR�LQFRUSRUDWH�WKH�3K\VLFLDQ�4XDOLW\�5HSRUWLQJ�6\VWHP�UHSRUWLQJ�UHTXLUHPHQWV�DQG�LQFHQWLYH�SD\PHQWV�LQWR�WKH�6KDUHG�6DYLQJV�3URJUDP��$&2�SDUWLFLSDQWV�WKDW�LQFOXGH�SURYLGHUV�VXSSOLHUV�ZKR�DUH�DOVR�HOLJLEOH�SURIHVVLRQDOV�IRU�SXUSRVHV�RI�WKH�3K\VLFLDQ�4XDOLW\�5HSRUWLQJ�6\VWHP�ZLOO�HDUQ�WKH�3K\VLFLDQ�4XDOLW\�5HSRUWLQJ�6\VWHP�LQFHQWLYH�DV�D�JURXS�SUDFWLFH�XQGHU�WKH�6KDUHG�6DYLQJV�3URJUDP��E\�UHSRUWLQJ�UHTXLUHG�FOLQLFDO�TXDOLW\�PHDVXUHV�WKURXJK�WKH�$&2�*URXS�3UDFWLFH�5HSRUWLQJ�2SWLRQ��*352��ZHE�LQWHUIDFH��LQ�HDFK�FDOHQGDU�\HDU�UHSRUWLQJ�SHULRG�WKH�$&2�IXOO\�DQG�FRPSOHWHO\�UHSRUWV�WKH�$&2�*352�PHDVXUHV�

Resources

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3

Page 4: Improving Quality of Care for Medicare Patients: …garnerhealth.com/.../2011/11/Improving-Quality-of-Care.pdfImproving Quality of Care for Medicare Patients: Accountable Care Organizations

Improving Quality of Care for Medicare Patients:

Accountable Care Organizations

Appendix

Quality Measures for Accountable Care Organizations

Domain Measure TitleNQF Measure

#/Measure Steward

Method of Data

Submission

Pay for Performance Phase InR = Reporting P = Performance

Performance Year 1 Year 2 Year 3

AIM: Better Care for Individuals

�� 3DWLHQW�Caregiver ([SHULHQFH

CAHPS:�*HWWLQJ�7LPHO\�&DUH��$SSRLQWPHQWV�� and Information

14)����

$+54

Survey 5 P P

��� 3DWLHQW�Caregiver ([SHULHQFH

CAHPS: How Well Your Doctors Communicate

14)���

$+54

Survey 5 P P

�� 3DWLHQW�Caregiver ([SHULHQFH

CAHPS:�3DWLHQWV¶�5DWLQJ�of Doctor

14)���

$+54

Survey 5 P P

�� 3DWLHQW�Caregiver ([SHULHQFH

CAHPS:�$FFHVV�to Specialists

14)���

$+54

Survey 5 P P

�� 3DWLHQW�Caregiver ([SHULHQFH

CAHPS: Health 3URPRWLRQ�DQG�(GXFDWLRQ

14)���

$+54

Survey 5 P P

�� 3DWLHQW�Caregiver ([SHULHQFH

CAHPS: Shared Decision Making

14)���

$+54

Survey 5 P P

�� 3DWLHQW�Caregiver ([SHULHQFH

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14)���

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Survey 5 5 5

�� Care &RRUGLQDWLRQ��3DWLHQW�6DIHW\

Risk-Standardized, All Condition Readmission1

14)��7%'

CMS

Claims 5 5 P

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Ambulatory Sensitive Conditions Admissions:Chronic Obstructive Pulmonary Disease�$+54�3UHYHQWLRQ�4XDOLW\�,QGLFDWRU��34,�����

14)�����

$+54

Claims 5 P P

1:H�QRWH�WKDW�WKLV�PHDVXUH�KDV�EHHQ�XQGHU�GHYHORSPHQW�DQG�WKDW�¿QDOL]DWLRQ�RI�WKLV�PHDVXUH�LV�FRQWLQJHQW�XSRQ�WKHDYDLODELOLW\�RI�PHDVXUHV�VSHFL¿FDWLRQV�EHIRUH�WKH�HVWDEOLVKPHQW�RI�WKH�6KDUHG�6DYLQJV�3URJUDP�RQ�-DQXDU\���������

4

Page 5: Improving Quality of Care for Medicare Patients: …garnerhealth.com/.../2011/11/Improving-Quality-of-Care.pdfImproving Quality of Care for Medicare Patients: Accountable Care Organizations

Improving Quality of Care for Medicare Patients:

Accountable Care Organizations

Domain Measure TitleNQF Measure

#/Measure Steward

Method of Data

Submission

Pay for Performance Phase InR = Reporting P = Performance

Performance Year 1 Year 2 Year 3

��� Care &RRUGLQDWLRQ��3DWLHQW�6DIHW\

Ambulatory Sensitive Conditions Admissions:Congestive Heart Failure�$+54�3UHYHQWLRQ�4XDOLW\�,QGLFDWRU��34,�����

14)�����

$+54

Claims 5 P P

��� Care &RRUGLQDWLRQ��3DWLHQW�6DIHW\

Percent of PCPs who Successfully Qualify for an EHR Incentive Program Payment

CMS (+5�Incentive 3URJUDP�5HSRUWLQJ

5 P P

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Medication Reconciliation: Reconciliation After Discharge from an Inpatient Facility

14)����

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5 P P

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Falls: Screening for Fall Risk

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5 P P

AIM: Better Health for Populations

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5 P P

��� 3UHYHQWLYH�Health

Pneumococcal Vaccination

14)����

1&4$

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5 P P

��� 3UHYHQWLYH�Health

Adult Weight Screening and Follow-up

14)�����

CMS

*352�:HE�Interface

5 P P

��� 3UHYHQWLYH�Health

Tobacco Use Assessment and Tobacco Cessation Intervention

14)����

$0$�3&3,

*352�:HE�Interface

5 P P

��� 3UHYHQWLYH�Health

Depression Screening 14)�����

CMS

*352�:HE�Interface

5 P P

��� 3UHYHQWLYH�Health

Colorectal Cancer Screening

14)����

1&4$

*352�:HE�Interface

5 5 P

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Mammography Screening

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5 5 P

5

Page 6: Improving Quality of Care for Medicare Patients: …garnerhealth.com/.../2011/11/Improving-Quality-of-Care.pdfImproving Quality of Care for Medicare Patients: Accountable Care Organizations

Improving Quality of Care for Medicare Patients:

Accountable Care Organizations

Domain Measure TitleNQF Measure

#/Measure Steward

Method of Data

Submission

Pay for Performance Phase InR = Reporting P = Performance

Performance Year 1 Year 2 Year 3

21. Preventive Health

Proportion of Adults 18+ who had their Blood Pressure Measured within the preceding 2 years

CMS GPRO Web Interface

R R P

22. At Risk Population – Diabetes

Diabetes Composite (All or Nothing Scoring): Hemoglobin A1c Control (<8 percent)

NQF #0729

MN Community Measurement

GPRO Web Interface

R P P

23. At Risk Population – Diabetes

Diabetes Composite (All or Nothing Scoring): Low Density Lipoprotein (<100)

NQF #0729

MN Community Measurement

GPRO Web Interface

R P P

24. At Risk Population – Diabetes

Diabetes Composite (All or Nothing Scoring): Blood Pressure <140/90

NQF #0729

MN Community Measurement

GPRO Web Interface

R P P

25. At Risk Population – Diabetes

Diabetes Composite (All or Nothing Scoring): Tobacco Non Use

NQF #0729

MN Community Measurement

GPRO Web Interface

R P P

26. At Risk Population – Diabetes

Diabetes Composite (All or Nothing Scoring): Aspirin Use

NQF #0729

MN Community Measurement

GPRO Web Interface

R P P

27. At Risk Population – Diabetes

Diabetes Mellitus: Hemoglobin A1c Poor Control (>9 percent)

NQF #59

NCQA

GPRO Web Interface

R P P

28. At Risk Population – Hypertension

Hypertension (HTN): Blood Pressure Control

NQF #18

NCQA

GPRO Web Interface

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29. At Risk Population – Ischemic Vascular Disease

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