Measurement Alignment Efforts First Step Towards Driving Health Improvements in the Commonwealth

Stephanie Clouser

Healthcare quality measurement is not sexy. Or at least that’s what my boss, KHC Executive Co-Director Randa Deaton, has said.

As the KHC Data Scientist, I disagree. And judging by the attendance at this month’s KHC Community Health Forum, “Driving Health Improvements Through Measurement Alignment,” I’m not the only one who disagrees. On September 10, we spent the morning with a full house of attendees to learn from national and local experts in healthcare measurement and measurement alignment.

The two-hour Forum highlighted national and local measurement alignment efforts aimed at reducing measurement burden, improving focus, and ultimately measuring what matters most to patients. This included:

  • The Core Quality Measure Collaborative (CQMC), a broad-based coalition of health care leaders convened by America’s Health Insurance Plans, Centers for Medicare and Medicaid Services (CMS), and the National Quality Forum (NQF)
  • Louisville-headquartered Humana’s journey to align their measures across product lines
  • The Kentucky Core Healthcare Measures Set, convened by the KHC
  • A panel of regional experts on the current landscape and future of healthcare measurement in the Commonwealth

Packed Agenda Highlighted Measurement Alignment Opportunities and Challenges

Norton Healthcare’s Dr. Joshua Honaker, Chief Medical Administrative Officer for Norton Medical Group, kicked off the morning with an introduction to the “measurement mayhem” that contributes to physician burnout and high administrative costs, highlighting the need for the streamlining of measures and incentives.

The morning’s keynote speaker, Chinwe Nwosu, America’s Health Insurance Plans, discussed the advancement of quality measurement and improvement through core measures sets. Nwosu, the project manager for the Core Quality Measures Collaborative (CQMC), a broad-based coalition of health care leaders convened by AHIP, CMS, and NQF. In her talk, Nwosu noted several challenges to the adoption of national core measures sets, including lack of interoperability, small sample sizes, and lack of alignment with state Medicaid and commercial measurement efforts. Some proposed strategies included standardization of measure implementation across payers, alignment of CMS reporting requirements with the core measures, identification of high-impact measures with strong relationships to outcomes, and increased data capacity of electronic health records and interoperability between registries.

Faith Green, Humana, talked about her organization’s journey to align their measures across product lines, including the lessons learned from their process, which reduced their number of metrics from 1,116 to 208. I then talked about the 2019 Kentucky Core Healthcare Measures Set (KCHMS), created by experts across the Commonwealth of Kentucky and convened by the KHC. The 2019 KCHMS, the second iteration of the core measures set, was released in August. The morning ended with an expert panel discussion about the current landscape and future of healthcare measurement in the Commonwealth.

Path Forward is Challenging but Promising

If the energy at our KHC Community Health Forum was any indication, the future of measurement alignment in the Commonwealth is a promising one. Much like the AHIP/CMS/NQF Core Quality Measures Collaborative, we are now at the point where we have a core set of key quality indicators that is ready for implementation among Kentucky’s various stakeholders.

From the beginning, more than two years ago, we have been truly overwhelmed by the response that we have gotten around this initiative. With the current state of healthcare work today, it is often challenging to get volunteers to commit to “one more thing” in addition to their already overextended workload. However, we were approached – enthusiastically, I might add – by individuals from all backgrounds to serve on this project, which speaks to the importance of this work.

What we have launched is not a small lift. Healthcare measurement alignment is tough work, and it’s not for the faint of heart. It isn’t easy to sift through hundreds of measures to identify the ones that will give us the greatest insight into how our healthcare systems are performing, while also continuing to honor the various reporting standards given by dozens of other organizations. However, while the daunting quality of the work has the potential to be a deterrent, it is important to push for reduction and alignment around meaningful measures that ultimately drive change in our community, reduce measurement burden, and improve adherence to evidence-based medicine and health outcomes.

Creating a core set of healthcare measures to focus and align priorities is just the first step toward aligning incentives around the things that matter. The Kentucky Core Healthcare Measures Set brings together the priorities of consumers, providers, payers, and purchasers specifically with the needs of the Commonwealth in mind. We need to push in the coming months to get this core measures set in use by our payers, providers, and purchasers. I feel a bit like a broken record, but as always, I want to finish with this thought: By focusing on everything, we focus on nothing. But by focusing on the right things, we can drive improvements.

Did you miss the KHC Community Health Forum, “Driving Health Improvements Through Measurement Alignment”? Click here to see the agenda and slide decks from the event.