NCQA testing new way to measure quality

Using data to measure health outcomes

The National Committee for Quality Assurance (NCQA) and the Robert Wood Johnson Foundation (RWJF) are evaluating a new measurement tool that they hope will be a better gauge of risk factors and focus on improving outcomes for heart disease and diabetes patients.

The NCQA is working with Archimedes, Inc. to develop a Global Cardiovascular Risk (GCVR) score, which will measure how well providers reduce the risk of future adverse outcomes in the populations they serve, like heart attacks, strokes, and diabetic complications. The tool uses electronic health records and the clinical information in them to assess improvement and prevent bad outcomes.

NCQA president Margaret O’Kane says the tool may be the first “customized, outcomes-based electronic health record measure used by Medicare and commercial payers. Its widespread adoption could have a profound impact on health care costs because it assesses how well providers engage in prevention and goal-setting for their high-risk patients.” She adds that it might just be the new “gold standard” for quality measurement and even replace some traditional measures.

Rather than processes of care and reaching clinically artificial treatment goals for biomarkers that provide little qualitative information about how patients actually do, the new tool will look at actual disease outcomes and evaluate how much the risk of future adverse events declines. The GCVR is a single metric that captures what every provider can do to prevent adverse outcomes, all integrated in a medically and clinically realistic way.

The project announced this spring will allow the NCQA to evaluate the feasibility of collecting data from EHRs to calculate a measurable result for different providers and provider organizations, as well as determine provider views on how useful and meaningful the GCVR score is for predicting risk.

For the next 18 months, NCQA will determine what data it can feasibly extract from health records. It is currently recruiting organizations to participate. The data collection and analysis will occur over the summer and fall of 2013, and NCQA expects to report findings by summer 2014.