NQF Identifies Efficient Care for 4 Conditions

Cheryl Clark, for HealthLeaders Media , April 9, 2012

For example, for asthma, the committee looked at costs incurred for inpatient or ambulatory services, such as evaluation and management, procedures and surgeries, imaging, and diagnostic care, laboratory, and admissions and discharges, the emergency department, pharmacy, evaluation and management, procedures and surgeries, laboratory and imaging, and diagnostic care.

The NQF earlier this month published an Endorsement Summary produced that explained, "Several provisions in recent policy require use of resource use data over the next several years to support efforts to move toward a value-based purchasing payment model.

"Furthermore, making quality care more affordable by developing and spreading new healthcare delivery models is one of the National Quality Strategy’s priorities. Understanding resource use measurement as a building block toward measuring efficiency and value is a critical step toward achieving these aims."

One of those recent policies requiring a harder look at resource use is the Affordable Care Act, which directs the Secretary of Health and Human Services to ensure that measures included in value-based purchasing incentive payments include a provision for efficiency, including "Medicare spending per beneficiary," adjusted for "age, sex, race, severity of illness and other factors that the Secretary determines appropriate," the NQF summary explained.

The National Quality Forum committee endorsed these four mechanisms for evaluating cost per episode of care on contract from HHS.

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