NPC, Discern Health Outline Ways to Improve Oncology Quality Measurement in Accountable Care

Comprehensive Study Conducted With Experts From Duke Margolis Center, ASCO Released Today

(Washington, DC, April 4, 2017)—The National Pharmaceutical Council and Discern Health today released a white paper analyzing the gaps in accountable care quality measure sets for cancer, which can lead to missed opportunities to spot problems or improve care. The white paper, “Improving Oncology Quality Measurement in Accountable Care,” was shared during the National Quality Forum’s (NQF) Annual Meeting.

Quality measurement tied to financial incentives is one approach accountable care programs use to promote system-wide improvement and ensure appropriate care delivery. Measures can help payers reward better care, providers to take action to improve care, and patients to make informed decisions about where to seek care. Measurement in oncology is particularly challenging because care often includes targeted diagnostics and therapeutics that are indicated based on individualized patient preferences and tumor markers.

“The treatment of cancer and our understanding of it is evolving at rapid speed,” said Kimberly Westrich, MA, NPC Vice President of Health Services Research and study co-author. “Given how personalized cancer care is, we need to look beyond measuring processes. It’s important to learn what’s missing from cancer quality measures in accountable care so that we can improve health outcomes and measure what is most meaningful to patients.”

The white paper, developed by NPC and Discern Health in conjunction with experts from the Duke Margolis Center for Health Policy and the American Society of Clinical Oncology (ASCO), provides insights into measure gaps for 10 high-priority types of cancers, including breast, chronic myelogenous leukemia, colon, kidney, melanoma, non-Hodgkin lymphoma, non-small cell lung, ovarian, pancreatic, and prostate cancer. It is an in-depth analysis following research published in the Journal of Managed Care & Specialty Pharmacy earlier this year.

To evaluate measure gaps, the authors compared existing quality measures to clinical practice guidelines developed by oncology professional societies. They convened oncology and measurement subject matter experts for a day-long meeting to evaluate gaps and identify opportunities for improving measures and measure sets.

Based on these analyses, the white paper recommends several ways to address oncology quality measurement challenges, such as:

• Refining oncology core measure sets with existing and new cross-cutting measures that address important quality issues across types of cancer.
• Gaining a better understanding of cancer-specific patient-reported outcome (PRO) data collection tools and PRO performance measures for accountable care through research and measure development.
• Designing and incentivizing reporting under a layered measurement approach to assess performance at provider, system, and external accountability levels. Reporting dashboards should capture aggregated quality results at all these levels.
• Leveraging best practices in model design and measure development from organizations such as the Health Care Learning & Action Network and the National Quality Forum.
• Collaborating to create an accessible repository for timely high-quality clinical evidence and a single entity to review and standardize clinical pathways based on evidence.
• Defining a core set of essential data elements for Electronic Health Records (EHRs) to ensure quality reporting while also standardizing defined core oncology data elements in Certified EHR Technology.

“One key takeaway from this research is that accountable care measure sets need to include patient-reported outcomes,” noted study co-author Discern Health Partner Tom Valuck, MD, JD. “By implementing the recommendations in the study, including building better infrastructure to collect patient-reported data, measure developers will be able to address the gaps that exist today.”

The white paper is a follow-on from prior NPC-supported work, the “Mind the Gap” white paper, two peer-reviewed publications, and a conference that explored challenges and solutions for closing gaps in health care quality measures.

NPC and Discern Health are hosting a webinar with the authors on April 26 from 1-2:30 pm EDT to discuss the white paper findings and recommendations. Registration is available via NPC’s website.