Webinar 5 Measure Development Education Outreach for Specialty

Webinar # 5 Measure Development Education & Outreach for Specialty Societies & Patient Advocacy Groups 1) CMS Measure Development Plan Presenters: Health Services Advisory Group Anita Somplasky Kendra Hanley 2) 2017 Consensus Development Process Redesign Presenters: National Quality Forum Elisa Munthali Wunmi Isijola

Vision and Goals: Webinar Series Measure Development Education & Outreach for Specialty Societies & Patient Advocacy Groups • An ongoing process to engage clinical specialty societies and patient advocacy groups in quality measure development. • Elicit feedback that will help CMS design toolkits and enduring materials specifically for specialty societies and patient advocacy groups interested in measure development. ü Education ü Outreach ü Frequent Communication ü Enduring Materials ü Dedicated Websites ü Measure Development Roadmaps ü Targeted Newsletters and Communication ü Showcase Opportunities 1

MDP & CDP Webinar # 5 Measure Development Education & Outreach for Specialty Societies & Patient Advocacy Groups Agenda Webinar # 5: 1. Review the CMS Measure Development Plan and the MDP Annual Report 2. Share the updated Consensus Development Process that NQF uses for measure endorsement 3. Questions and Answers 4. Announcements and Updates 2

HSAG Measure Development Plan Health Services Advisory Group: 2017 Measure Development Plan and Annual Report Anita Somplasky Kendra Hanley

Measure Development Plan Webinar # 5 CMS Measure Development Plan (MDP) & MDP Annual Report Objectives and Background 4

Measure Development Plan Webinar # 5 Objectives for Today • Review the purpose of the Measure Development Plan (MDP) and the MDP Annual Report required under the Medicare and CHIP Reauthorization Act of 2015 (MACRA) • Provide overviews of key components and processes described in the MDP, and the MDP Annual Report posted on the CMS. gov website: https: //www. cms. gov/Medicare/Quality-Initiatives. Patient-Assessment-Instruments/Value-Based. Programs/MACRA-MIPS-and-APMs/Final-MDP. pdf 5

Measure Development Plan Webinar # 5 Background – MACRA Snapshot Medicare and CHIP Reauthorization Act (MACRA) Section 101 Advanced Alternative Payment Models (APMs) Merit-based Incentive Payment System (MIPS) Quality Payment Program Section 102 Measure Development Plan (MDP) MDP Annual Report Clinician Measures 6

Measure Development Plan Webinar # 5 Measure Development Plan & Purpose The purpose of the MDP is to meet the requirements of the statute and: • Serve as a strategic framework for the future of clinician quality measure development to support the Quality Payment Program • Recommend prioritized approaches to close measure and performance gaps 7

Measure Development Plan Webinar # 5 Vision for the MDP • CMS will evaluate and build upon existing quality measure sets to develop a person-centered portfolio of measures that can drive improvement in health outcomes • The strategic vision draws from the CMS Quality Priorities, the Blueprint for the CMS Measures Management System (MMS Blueprint), as well as CMS general and technical principles for measure developers • The MDP integrates recommendations from recent relevant publications and stakeholders, where applicable 8

Measure Development Plan Webinar # 5 Core Components of the MDP MMS CMS Quality Priorities Blueprint General Technical Principles Quality Measure Development Plan 9

Measure Development Plan Webinar # 5 CMS Quality Priorities • Articulates six goals to improve the quality of care in our health system: 10

Measure Development Plan Webinar # 5 CMS Measures Management System (MMS) • In 2005, CMS introduced the MMS Blueprint as a standardized approach for developing and maintaining quality measures – The approach addressed the need to manage an everincreasing demand for quality measures in CMS public reporting and quality programs – The primary goals of the MMS Blueprint are to provide clinical technical information to ensure that measure developers consistently produce high-caliber, person-centered measures 11

Measure Development Plan Webinar # 5 CMS General & Technical Principles • CMS has identified a number of measure development principles to guide the development of quality measures • CMS intends to require organizations that develop measures for MIPS and APMs to embrace these principles • CMS general and technical principles may be found in Appendix I of the Measure Development Plan 12

Measure Development Plan Webinar # 5 CMS Measure Development Plan (MDP) & MDP Annual Report The MDP Annual Report 13

Measure Development Plan Webinar # 5 Statutory Requirements of the MDP Annual Report • Report on progress made in: – Developing measures for the Quality Payment Program – Implementing the MDP • Detail updates to the MDP, including newly identified gaps and previously identified gaps • Describe quality measures developed and in development during the previous year • Provide an inventory of applicable quality measures 14

Measure Development Plan Webinar # 5 Updates to the MDP, including Gaps (Previously & Newly Identified Gaps) • Goals of the MDP Environmental Scan • Determine how many existing measures are applicable to the priority domains, topics, and specialties identified as CMS MDP priorities • Identify gaps in measurement areas for future measure development 15

Measure Development Plan Webinar # 5 Environmental Scan & Gap Analysis Process 16

Measure Development Plan Webinar # 5 Convene a Technical Expert Panel The purpose of the Technical Expert Panel (TEP) is to: • Provide direction for the MDP • Review and provide input on findings of the environmental scans • Prioritize future measure development 17

Measure Development Plan Webinar # 5 Report on Measures Developed or in Development • Quality measures developed – – Number that completed development CMS Priority category How the measure is specified Annual expenditures • Quality measures in development – – Number in some stage of development Clinical priorities How the measure is specified Combined expenditures 18

Measure Development Plan Webinar # 5 Inventory of Applicable Measures in the Quality Payment Program • The Annual Report informs measure developers and stakeholders regarding: – The number of MIPS measures for the Quality Payment Program reporting year – Measures included in Advanced Alternative Payment Models (APMs) – Available Qualified Clinical Data Registries (QCDRs) • Number of QCDRs that can report MIPS measures in addition to CMSapproved measures specific to each registry 19

Measure Development Plan Webinar # 5 Conclusions & Next Steps • The CMS MDP is the strategic framework for the future of clinician quality measure development to support the Quality Payment Program • The MDP Annual Report – Focuses on prioritized measurement gaps for future measure development – Evaluates the measurement portfolio to ensure measures function as intended and reflect clinical practice – Assesses measures applicable to MDP priorities for potential inclusion in the Quality Payment Program 20

Measure Development Plan Webinar # 5 CMS Measure Development Plan and MDP Annual Report Questions? 21

NQF Consensus Development Process Redesign National Quality Forum: 2017 Consensus Development Process Redesign Elisa Munthali, MPH Wunmi Isijola, MPH

CDP Redesign Webinar # 5 Background • NQF hosted a Kaizen event on May 18 -19, 2017 to explore opportunities for a more agile and efficient Consensus Development Process (CDP) • NQF, in collaboration with CMS, sought to : – Improve coordination among CMS, developers, and NQF to better facilitate timely evaluation of measures – Increase opportunities for submission and timely review of measures – Reduce cycle time of the CDP – Improve flow of information between the CDP and Measure Applications Partnership (MAP) processes 23

CDP Redesign Webinar # 5 Changes to the Consensus Development Process All changes effective October 2017 More frequent measure submission opportunities New intent to submit process A newly-formed NQF Scientific Methods Panel to augment committees’ review of reliability and validity • Expanded and continuous commenting period—with support/non-support • Change in the content and structure of the measure evaluation technical report • Enhancements in stakeholder training and education • • 24

CDP Redesign Webinar # 5 NQF Consensus Development Process (CDP) 6 Steps for Measure Endorsement • Intent to Submit* • Call for Nominations • Measure Evaluation* – New structure/process – Newly formed NQF Scientific Methods Panel – Measure Evaluation Technical Report • Public Commenting Period with Member Support* • Measure Endorsement • Measure Appeals * New improvements 25

CDP Redesign Webinar # 5 More Frequent Measure Submission Opportunities • Two measure submission opportunities (cycles) for every topic area, each year – November and April • Number of measures evaluated by standing committees in each cycle limited to a maximum of 12 – 8 maintenance measures and 4 newly-submitted measures • Consolidated measure review topical areas from 22 to 15 – Balance the size of various NQF portfolios – Group cross-cutting clinical areas – Re-distribute measures to committees with needed expertise 26

CDP Redesign Webinar # 5 Intent to Submit • Measure stewards/developers required to notify NQF at least 3 months prior to the measure submission deadline • Requirements include, numerator and denominator statements, measure type and level of complexity, planned submission date • Implementation – Soft launch – Cycle 1 2017 (November 2017 submission deadlines) – Full launch – Cycle 2 2018 (April 2018 submission deadlines) 27

CDP Redesign Webinar # 5 Scientific Methods Panel • Conduct evaluation of complex measures for the criterion of Scientific Acceptability, with a focus on reliability and validity analyses and results – Promote more consistent evaluations of Scientific Acceptability criterion – Reduce standing committee burden – Promote greater participation of consumers, patients, and purchasers on NQF standing committees • Serve in an advisory capacity to NQF on methodologic issues, including those related to measure testing, risk adjustment, and measurement approaches 28

CDP Redesign Webinar # 5 Scientific Acceptability Review 29

CDP Redesign Webinar # 5 Commenting, Technical Report, and Training and Education • One extended commenting period – NQF members will have the opportunity to express their support/or not for each measure • Technical report less dense and will include most relevant information (e. g. measure summaries, specifications) • More training and education opportunities for all stakeholders 30

CDP Redesign Webinar # 5 2017 Consensus Development Process (CDP) Redesign 31

CDP Redesign Webinar # 5 Resources • Consensus Development Process: http: //www. qualityforum. org/Measuring_Performance/Consensus_Dev elopment_Process. aspx • Submitting Standards: http: //www. qualityforum. org/Measuring_Performance/Submitting_Stan dards. aspx – 2017 Measure Evaluation Criteria – Developer Guidebook • Measuremaintenance@qualityforum. org 32

CDP Redesign Webinar # 5 Points of Contact • Elisa Munthali, Acting Senior Vice President, Quality Measurement – emunthali@qualityforum. org • Wunmi Isijola, Managing Director, Quality Measurement – wisijola@qualityforum. org 33

CDP Redesign Webinar # 5 Questions For Our Presenters? 34

MDP & CDP Webinar # 5 References • CMS Measure Development Plan – https: //www. cms. gov/Medicare/Quality-Initiatives. Patient-Assessment-Instruments/Value-Based. Programs/MACRA-MIPS-and-APMs/Final-MDP. pdf • CMS MDP Annual Report – https: //www. cms. gov/Medicare/Quality-Initiatives. Patient-Assessment-Instruments/Value-Based. Programs/MACRA-MIPS-and-APMs/2017 -CMS-MDP -Annual-Report. pdf 35

MDP & CDP Webinar # 5 References • NQF Consensus Development Process – https: //www. qualityforum. org/Measuring_Performance/C onsensus_Development_Process. aspx • Submitting Standards – http: //www. qualityforum. org/Measuring_Performance/Su bmitting_Standards. aspx 36

CMS Showcase Opportunities Measure Development Education & Outreach for Specialty Societies & Patient Advocacy Groups Reminder: If you are currently developing quality measures that you would like to present to CMS, contact the MMS Support Desk at MMSsupport@Battelle. org 37

MDP & CDP Webinar # 5 Measure Development Education & Outreach for Specialty Societies & Patient Advocacy Groups Planned Upcoming Webinars: • January 17, 2018: CMIT and the CMS Measures Inventory • February 7, 2018: The Measure Development Process: Conceptualization • Suggestions for future topics? • Email: MMSsupport@battelle. org 38

MDP & CDP Webinar # 5 Measure Development Education & Outreach for Specialty Societies & Patient Advocacy Groups Contact information: • Battelle Measures Management System Contract Holder: Battelle Contact: MMSsupport@Battelle. org • CMS Golden Horton: Golden. Horton@cms. hhs. gov Kimberly Rawlings: Kimberly. Rawlings@cms. hhs. gov 39