Developing a National Framework for Making Performance Information Available
 
Engelberg Center staff, in support of QASC and working with America’s Health Insurance Plans Foundation and a broad range of public and private collaborators, is developing a nationally-consistent data aggregation methodology to combine data from multiple health plans for performance measurement.
 
The nationally-consistent data aggregation methodology closely aligns private and public sector performance measurement efforts. Combining public and private sector performance information yields a more complete and accurate picture of the quality of the data. Generated performance information will measure individual physicians and aggregated for entities in which doctors share tax identification numbers.  Future efforts, where feasible, may focus on measuring performance of medical groups and physician practices.
 
The approach will be tested in two areas of the country in the months ahead. Demonstrated success will allow expansion to other areas of the country. Through collaboration and coordination with regional initiatives already underway this approach will help identify best practices in performance measurement and support efforts around the country to make needed performance information available as quickly, consistently, and efficiently as possible. The scarce local resources of private- and public-sector organizations can then be used for quality improvement  or for  enhancement of the performance information where desired rather than developing and maintaining disparate performance measurement efforts.
 
The nationally-consistent data aggregation methodology that is being developed also ensures privacy of patient information. Patient’s privacy will be protected, and personal health information will stay with the original owners of the data, but doctor’s will be able to access lists of patients through a single interface.
 
The QASC is also pursuing steps to integrate clinical data (e.g., lab data) with claims data. For example, cancer-related activities will focus on re-engineering and re-orienting parts of the existing cancer data infrastructure (e.g., tumor registries), ultimately enhancing provider and patient decision-making during treatment, adherence to evidence-based treatment guidelines, and performance-based provider payment options. Pilot studies will determine the most accurate and timely sources of various pieces of diagnostic and treatment information.
 
The Engelberg Center’s work will address two additional disease areas. Cardiovascular disease-related activities will focus on the use of specialty society registries to provide better clinical data for performance measurement and assessment of comparative effectiveness in treating acute myocardial infarction (AMI) and congestive heart failure (CHF) patients. Pilot projects will link databases and produce cardiovascular care performance measures to support quality improvement, payment reform, and public transparency. Finally, diabetes-related activities will focus on linking patient lab results that monitor management of their disease with claims data that contain information on use and cost of services.