Since spring 2011, the American Nurses Association (ANA) has been engaged as an organizational member in a national initiative to identify health care quality performance measures that would provide the foundation for federal public reporting and performance-based payment programs. The Measure Application Partnership (MAP) recently submitted its first annual review of performance measures
that will be used to inform federal rules focused on core measures for public reporting and pay for quality that govern about 20 federal health care programs.
MAP, a public-private partnership, was established by the Affordable Care Act and convened by the National Quality Forum, which endorses evidence-based quality measures and organizes partnerships to build consensus on national health care priorities.
Establishing measures to evaluate the quality of care is crucial to improving patient outcomes, including safety. Performance measures can be used to hold health care providers, such as hospitals, clinicians, and teams, accountable for the quality of care they provide, and to help government and private insurers set financial incentives for providers.
ANA CEO Marla J. Weston, PhD, RN, serves on the MAP’s Coordinating Committee, which sets strategy, coordinates several advisory workgroups, and advises the U.S. Department of Health and Human Services (HHS) on quality measures. MAP identified principles and selection criteria for choosing quality measures. The partnership also identified areas with critical gaps in quality measures, such as care coordination, patient engagement and team-based shared accountability.
ANA has been a leader in developing nursing quality performance measures since the 1990s with the establishment of the National Database for Nursing Quality Indicators® (NDNQI®), which collects data on measures linking nursing services and care processes with patient outcomes.
MAP includes 60 organizations representing public and private sector health care stakeholders, including employers, consumers, labor, clinicians, health plans, hospitals and other health care facilities. MAP represents the first time the federal government has sought input from a public-private collaboration on which quality measures should be added for use in federal health care programs, prior to proposing and adopting rules. HHS sought input on 350 measures and potential measures of health care quality.
Previously, HHS typically has issued proposed rules with public comment periods, followed by final rules on quality measures for one federal program at a time. As a result, there was a lack of core, harmonized measures for use across settings of care and federal programs. MAP is committed to identifying coordinated strategies and core measure sets for use across federal programs and, in the future, across health care payers.