AQA-HQA Steering Committee Meeting
December 12, 2006
Welcome and Update from AHRQ and CMS
Carolyn Clancy welcomed the group. Dr. Clancy stated that the next in-person meeting would be on January 10th.
Leslie Norwalk reaffirmed that CMS remains committed to this public-private endeavor. Ms. Norwalk reported that CMS is still reviewing the very recently passed changes to Medicare physician reimbursement. She noted that the Congress wants CMS to use a consensus–based approach to physician measure development and pay for performance and noted that the QASC was a good vehicle. CMS remains committed to sharing Medicare data and is working with the Office of General Counsel on approaches. She also noted that the pilots and QASC workgroups are making progress.
Update on Employer Outreach
Andrew Croshaw reported that on November 17th an Employer Summit sponsored by the Business Round Table took place. The goal is to sign up 100 top employers by the end of the year. Organizations already signed up are listed on the HHS website.
Mark McClellan, Vice-Chair of the QASC, reported on his efforts to get outside funding partners. Dr. McClellan reported that he had strong interest from at least one foundation and is putting a grant proposal together. The grant would focus on identified gaps in such areas as data aggregation, health disparities measurement, and the need for a mechanism for experimentation. Dr. McClellan reported on data aggregation and that it was important to gain support from health plans so private sector data could be pooled with Medicare data to form a more comprehensive and accurate view of physician performance.
Work Group Reports
Pilot Expansion: Peter Lee
The Pilot Expansion group has gained agreement on criteria and core functions of Value Exchanges [term now used to denote the next generation of pilots or community collaboratives] as well as enabling factors needed. The group also reached agreement on the chartering terms/expectations of Value Exchanges. Processes still unresolved include data collection models, the timeline for measure development, and “chartering” of Value Exchanges.
Collection models- there was a great deal of discussion about collection and use of data on both the national and local levels, and the need to balance both of these using a hybrid model. A core set of measures needs to be selected soon. Timeline-the group is charting out a timeline for the measurement enterprise.
Chartering- the discussions around chartering focused on the benefits of being chartered (getting recognition, involvement in the learning network, receiving a performance report, public/private funding) and selection criteria and who should do the selecting (NQF, AHRQ, Secretary’s office, etc.)
Infrastructure Support: Chris Queram
The Infrastructure Support group has agreement on the need to create a nation-wide Learning Network of Value Exchanges to foster peer to peer learning and identification and adoption of best practices. They also agreed on the critical role of evaluation of activities.
Measure Harmonization: Janet Corrigan
The Measure Harmonization group has eight focused review teams who will have final recommendations for harmonization s by January 10th. She noted the actual harmonization would take approximately 16-18 months.
Cost-Price Transparency: Debra Ness/Bruce Bradley
The Cost-Price Transparency group has had a conference call as well as an all day face to face meeting. They are meeting next week to finalize principles on consumer reporting that promote purchasing decisions in two areas: 1) how much the care will cost the consumer and 2) comparative information. They will also move on to filling in a framework about who should report what to whom and then a plan for implementation. The group agreed that cost data should be linked with quality information where possible.
Efficiency-Episodes of Care: Kevin Weiss/Gregg Meyer
The Efficiency-Episodes of Care group agreed to build on principles already available from AQA and other groups working on this topic. Kevin noted that there is enough overlap of workgroup members with AQA and the NQF workgroup that the ultimate products will be aligned.
Note: A recently created Vision Work Group, co-chaired by Bob Dickler and Carmella Bocchino, will report on progress at the January 10 meeting.
General Discussion/Summary of Next Steps
It was noted that minutes of all the workgroup meetings are on the www.aqaalliance.org website, and are a rich source of more comprehensive information on the work of the groups. Comments and/or questions were solicited. One specific suggestion was to include work that would support communication with the public about how to use information on quality and cost of care in the grant proposal Mark McClellan is drafting.
The next meeting will be a two hour face to face meeting January 10th.
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