Designed to cut diabetes, cardiovascular (CV) disease and primary care costs, the National Quality Forum (NQF) Board of Directors has approved for endorsement four measures on healthcare resources use and costs. The measures provide data on how resources are used in these areas of care, and are intended to help create a more efficient, less wasteful healthcare system.
The endorsed measures are:
- 1557: Relative Resource Use for People with Diabetes (NCQA)
- 1558: Relative Resource Use for People with Cardiovascular Conditions (NCQA)
- 1598: Total Resource Use Population-based per member per month Index (HealthPartners)
- 1604: Total Cost of Population-based per member per month Index (HealthPartners)
According to NQF, the resource use measures can help both providers to better manage costs and care delivery, and health plans and consumers to better identify quality, cost-efficient providers.
Resource use measures are defined by the NQF as comparable measures of actual dollars or standardized units of resources applied to the care given to a specific population or event, such as a specific diagnosis or procedure.
Spurred on by government and private payor interest, this is the NQF's first effort at endorsing measures that evaluate how resources are used in care delivery. Several provisions in recent policy require use of resource data over the next several years to support efforts to move toward a value-based purchasing (VPB) payment model, and private payors have been utilizing these types of measures for several years.
NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of any of the four endorsed quality measures by submitting an appeal no later than February 29. To submit an appeal, go to the NQF Measure Database. For an appeal to be considered, the notification must include information clearly demonstrating that the appellant has interests directly and materially affected by the NQF-endorsed recommendations and that the NQF decision has had (or will have) an adverse effect on those interests.
Source: NQF, January 31, 2012
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Diabetes Management in the Medical Home
The chief operations officer at Hudson River HealthCare (HRHC) shares the inside details on HRHC’s diabetes management program and the program's impact on its diabetic patients. The program, in place for over 12 years, combines attributes from both the Institute for Health Improvement and the Wagner Chronic Care Model, to manage diabetic care for more than 3,400 adults.
Diabetes Management in the Medical Home is available from the Healthcare Intelligence Network for $129 by visiting our Online Bookstore or by calling toll-free (888) 446-3530.