08-03-2023_BoardBook

Quality Measurement by Care Setting

There are different healthcare quality measures for various healthcare settings. Common

settings include hospitals, health insurance plans, medical groups, clinicians, long-term care providers,

such as nursing homes, home health agencies, and hospice. For this paper, we will focus on the

healthcare settings where obesity care often takes place and stakeholders who are involved, including

hospitals, health insurance plans, and medical groups/clinicians. Quality measures by healthcare setting

are summarized in the Appendix, Table 2.

Hospital Quality Measures

Hospital care quality measurement focuses on measuring and reporting clinical effectiveness,

health outcomes, patient safety, and patient experiences with care received during a hospital stay. Each

year, hospitals participating in Medicare and Medicaid (CMS), which includes most hospitals in the U.S.,

are required to report on quality measures as a part of the Acute Care Hospital Quality Improvement

Programs. The programs include the Hospital Inpatient Quality Reporting (IQR) Program, Hospital Value

Based Purchasing (VBP) Program, Hospital-Acquired Condition Reduction Program (HACRP), Hospital

Readmissions Reduction Program (HRRP), and the Hospital Outpatient Quality Reporting (OQR) Program

(CMS, Hospital Inpatient Quality Reporting (IQR) Programs Measures, 2022). Across these programs,

participating hospitals report on numerous measures. The IQR program reports on 25 measures, VBP

reports on 24 measures (CMS, Hospital Value-Based Purchasing Program, 2022), HACRP program reports

on five measures (CMS, Hospital-Acquired Condition Reduction Program Measures, 2022), HRRP reports

on six measures (CMS, CMS QualityNet, 2022), and the OQR program reports on 15 measures (CMS,

Hospital Outpatient Quality Reporting Program Measures, 2022). Hospital care measures are typically

collected by digital administrative and claims data providing information on patient demographics,

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