08-03-2023_BoardBook

Key Healthcare Quality Organizations

Several key organizations play integral roles in quality measure development, endorsement, and

implementation (Figure 2). The National Committee for Quality Assurance (NCQA) develops measures

and standards that health care professionals use to identify areas they can improve and where health

plans report on. CMS is the government agency with a leading role in healthcare quality. They often

develop quality measures under contract with other entities, such as consulting firms or measure

developer organizations like NCQA or MNCM. CMS uses quality measures in its Medicare and Medicaid

quality initiatives that include pay for reporting, performance, and public reporting (i.e., MIPS). The

Minnesota Community Measurement (MNCM) is another notable measure developer organization that

recommends measurement priorities, specifications, guiding principles and policies for public reporting

of measurement data. While MNCM has a large presence in their home state and regionally, several of

their measures have achieved National Quality Forum (NQF) endorsement and acceptance into federal

quality payment programs. MNCM is recognized for its development of patient reported outcome-based

performance measures in the areas of depression, asthma, orthopedics and COPD, as well as the clinical

measure D5 for Diabetes care (MNCM, 2022).

The National Quality Forum (NQF) is a quality measure endorsement organization. NQF reviews

measures developed by other organizations, such as NCQA, CMS, or MNCM, and gathers input from

stakeholders across the healthcare ecosystem during the endorsement process. They use four criteria to

assess a measure for endorsement, including whether the area is important to measure and report,

whether the measure is scientifically acceptable, whether the measure is useable, and if the measure is

relevant and feasible to collect (NQF, The ABCs of Measurement, 2022). NCQA, in addition to measure

development, also evaluates health insurance plans for customers using HEDIS data. HEDIS is widely

used to measure and improve health care quality among government, health plans, provider

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