Nqf In Healthcare

Introduction

The United States has made significant investments in healthcare quality measurement and improvement. The emphasis on quality measurement has been viewed as fundamental to systematically improving health system performance. Despite major efforts on the part of both public and private payers to drive quality improvement by mandating measurement and reporting, promoting and funding quality improvement initiatives in the health care delivery system, and attempting to identify and pay for comparatively higher quality, progress has been slow, limited and uneven.

System-related issues, such as the complexity, lack of alignment and fragmentation of the US health care system, are frequently cited as reasons for these disappointing results.

Using a rigorous evaluation and review process by multiple stakeholders, NQF endorsed measures are considered the gold standard in measurement. NQF’s standing as a consensus based standard setting organization allows the federal government to preferentially use endorsed measures in their programs. NQF has assumed other responsibilities including measure selection. Each year, NQF advises the government on selection of measures for more than twenty federal public reporting and pay-for-performance programs. NQF also helps to support measure alignment across public and private sectors. Increasingly, NQF has taken on a leadership role in measurement science, with expert and consensus reports on complex and controversial issues in measurement, including adequacy of risk adjustment and strategies to link cost and

Over the years, the evaluation criteria have evolved into a hierarchy. Importance to measure and report reflects the greatest potential of driving improvement and resides at the top of the hierarchy. If a measure is not important, the other criterion are less important. This must-pass criterion focuses the evidence for the measure focus and gaps in care, with demonstrated considerable variation or less-than-optimal performance across providers and populations. The evidence criterion requires a systematic review or an assessment of the quality, quantity and consistency of the body of evidence for the measure focus. For outcome measures, NQF only requires a rationale that supports the relationship between the outcome and at least one process, intervention or service. The must-pass second criterion in the hierarchy is scientific acceptability of measure properties. The goal is to make valid conclusions about quality. If a measure is not reliable and valid, then there may be risk of misclassification and improper interpretation. The third criterion focuses on the usability and use of the measures. The goal is to use endorsed measures for decisions related to accountability and improvement. This criterion also considers whether the benefits of the measure outweigh evidence of unintended