Thus, "these measures contain known errors," Foster wrote, adding that pilot testing, specifically quality measures for stroke and venous thromboembolism, "was never conducted."
Yet, "these specifications were finalized by CMS and vendors embedded them into their products using the e-specifications provided."
GAO Finds Serious Problems
In mid-January, the GAO report took both the NQF and the Department of Health and Human Services to task for delays, cost overruns, and for failing to complete critically important endorsement work needed to write incentive payment programs, including the value-based purchasing and EHR Meaningful Use rules.
In an interview with HealthLeaders Media last week, the GAO report's author, Linda Kohn, characterized the problems the agency found as "serious" ones that threaten the credibility of measure based incentive payment programs.
"If there's any question about the measures underneath these programs, these programs themselves will be questioned. The measures have to be sound and workable. That's what the NQF does," she says.
Her report was specific. "For more than half of the projects, NQF did not meet or did not expect to meet the initial time frames approved by HHS."
For example, HHS used 44 measures NQF had converted for the EHR incentive program, but the measures required corrections. "HHS officials also have not tested the retooled measures to assess the feasibility of implementing them in the electronic format; therefore, HHS runs the risk that some of these measures may not work as intended when implemented," Kohn's report said.
"HHS may be unable to ensure that the agency receives the quality measures needed to meet (Affordable Care Act) requirements, including time frames for implementing quality measurement programs," the agency said.