Powerful State Quality Advisory Committee Begins Work

Health reform in Massachusetts is an ever moving river of change.   New legislation is expected within the month from both the Massachusetts Senate and House offering plans for more and faster delivery system reform.  In February,  the state began moving at an even faster pace to implement legislation from last session entitled “An Act to Promote Cost Containment,  Transparency and Efficiency in the Provision of Quality Health Insurance for Individuals and Small Business.”

Ostensibly, this new law is intended to guide and govern the establishment of selective or tiered (and presumably less expensive) health plan offerings.  The law charges  the Massachusetts Department of Public Health with promulgating regulations requiring the uniform reporting of a standard set of health care quality measures by each “health care provider facility, medical group, or provider group.”   The idea behind this new and potentially quite expansive quality data collection (and reporting) is to allow business who are buying (and consumers who are choosing) these selective network plans to make decisions based on comparable quality measures.  These quality measures may also eventually aid state government in measuring the performance of various and soon to be operating integrated healthcare systems, such as ICOs, ACOs, and PCMHs.

Not counting ex officio government officials, the Committee has only six members who are charged with selecting these measures.   While the Committee has significant discretion, the enabling legislation established some priorities and data sets that they must consider, including – for hospitals- using some data from the CMS process measures, HCAHPS and HEDIS.

At their most recent meeting, the Committee considered the 170 data elements contained in these three hospital measure sets and began narrowing it down  – based on evaluation of validity, reliability and practicality (ease of accessing)  – to 30 or 40 elements that may emerge as strongly recommended for inclusion in what would become a standard quality measure set for the state.

The legislation also instructed that the Committee consider as quality improvement priority areas: care transitions and care coordination, behavioral health and post acute care.  The Committee has yet to tackle these areas and has been clear that their areas of initial focus remain hospitals and community health centers.   Although the Committee did in March solicit public opinion as to others measures to consider beyond the hospital ones mentioned above (and the Alliance did send in comments), as the Committee is structured only recommendations will be truly considered that are put forth by one of the six committee members.

This Committee is moving quickly.  Post acute care and care transitions are on the agenda for their April 12th meeting in Boston.

Author: Pat Kelleher

Pat Kelleher is Executive Director of the Home Care Alliance of Massachusetts.

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