The National Quality Forum (NQF) that is (not the 1966 Zero Mostel classic as in the title of this blog). On February 5-6, 2015 NQF dove into rural quality issues for the first time by hosting the “Performance Measurement for Rural Low-Volume Providers: Rural Health Committee In-Person Meeting” at the NQF headquarters in Washington, DC. The NQF is a membership organization (NRHA is a member) that gives its “seal of approval” to quality measures developed in the health care industry. In addition, CMS contracts with NQF to help CMS select measures that are used in Medicare quality measurement programs, such as the Hospital Inpatient Quality Reporting (IQR) and Value-based Purchasing (VBP).
By urging of the Federal Office of Rural Health Policy (FORHP), CMS issued a contract with NQF to prepare a report on the following:
- A consensus set of measurement challenges for low-volume providers
- Make recommendations regarding measures appropriate for use in CMS pay-for-performance programs for rural hospitals and clinics
- Make recommendations to help mitigate measurement challenges, including low-case volume
- Identify measurement gaps for rural hospitals and providers
Rural providers have been negatively impacted by quality measurement systems over the years designed for large, urban tertiary centers and then super-imposed into the small, rural facility. The outcome was to have data that didn’t adequately measure what small volume facilities do and more importantly, yielded an impression to payers and the public that simply wasn’t true. As health care evolves into a value-driven environment, the need for low-volume measurement programs that describe what these facilities do and can make distinctions for payment purposes has never been higher.
So, for two days twenty rural health professionals from all over the country covering various areas of professional interest met and worked on this important topic. This group was passionate and spot-on regarding comments. I was pleased to work with other NRHA leaders on this group: Ann Abdella, John Gale, Ira Moscovice and Tim Size.
A report will be written by NQF using this committee’s input and delivered to CMS later this year. A funny thing did happen on the way to the forum, the NQF got schooled in rural. Let’s hope CMS takes this report seriously and uses it as a roadmap for quality reform for rural.