CORDATA BLOG

Care Coordination Quality Measures: A List of NQF Endorsements

Posted by Cam McClellan Teems

August 25, 2017 at 7:25 AM

   

Accurately assessing care quality is a tricky task. The number of quality measures to choose from for reporting can seem overwhelming. And attempting to sift through them all can be an even tougher undertaking. Because the standards for quantifying quality come from many sources, it’s often challenging to figure out which are the best fit for your specialty, or lead to the most meaningful improvement.

Luckily, the National Quality Forum (NQF) endorses certain measures for healthcare processes and outcomes. These standards have, as a whole, become an industry benchmark and denote a certain level of legitimacy. But that doesn’t mean it’s any easier to figure out which measures your practice will benefit most from. So, here’s a concise list of NQF-endorsed measures specifically tailored to care coordination in one easy read.

You can reference the supporting quality organization after the measure name for further info. Also, please note that while these are not specialty care coordination measures, they can be applied to specialty patient populations.

NQF Endorsed Measures for Care Coordination

*All measures and descriptions taken from the National Quality Forum Endorsement Summary

0097: Medication Reconciliation (NCQA)

Percentage of patients aged 65 years and older discharged from any inpatient facility (e.g., hospital, skilled nursing facility, or rehabilitation facility) and seen within 30 days of discharge in the office by the physician, prescribing practitioner, registered nurse, or clinical pharmacist who had reconciliation of the discharge medications with the current medication list in the outpatient medical record documented.

0171: Acute Care Hospitalization (Risk-Adjusted) (CMS)

Percentage of home health stays in which patients were admitted to an acute care hospital during the 60 days following the start of the home health stay.

0173: Emergency Department Use Without Hospitalization (CMS)

Percentage of home health stays in which patients used the emergency department but were not admitted to the hospital during the 60 days following the start of the home health stay.

0326: Advance Care Plan (NCQA)

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record, or documentation in the medical record that an advance care plan was discussed but the patient did not wish, or was not able to, name a surrogate decision maker or provide an advance care plan.

0494: Medical Home System Survey (NCQA)

The following six composites are generated from the Medical Home System Survey (MHSS). Each measure is used to assess a particular domain of the patient-centered medical home.

  • Measure 1: Improved access and communication
  • Measure 2: Care management using evidence-based guidelines
  • Measure 3: Patient tracking and registry functions
  • Measure 4: Support for patient self-management
  • Measure 5: Test and referral tracking
  • Measure 6: Practice performance and improvement functions

0526: Timely Initiation of Care (CMS)

Percentage of home health episodes of care in which the start or resumption of care date was either on the physician-specified date or within 2 days of the referral date or inpatient discharge date, whichever is later.

0553: Care for Older Adults – Medication Review (NCQA)

Percentage of adults 66 years and older who had each of the following during the measurement year: advance care planning, medication review, functional status assessment and pain assessment.

0554: Medication Reconciliation Post-Discharge (NCQA)

The percentage of discharges from January 1 – December 1 of the measurement year for members 66 years of age and older for whom medications were reconciled on or within 30 days of discharge.

0646: Reconciled Medication List Received by Discharged Patients (Discharges from an Inpatient Facility to Home/Self Care or Any Other Site of Care) (AMA-PCPI)

Percentage of patients, regardless of age, discharged from an inpatient facility (e.g., hospital inpatient or observation, skilled nursing facility, or rehabilitation facility) to home or any other site of care, or their caregiver(s), who received a reconciled medication list at the time of discharge including, at a minimum, medications in the specified categories.

0647: Transition Record with Specified Elements Received by Discharged Patients (Discharges from an Inpatient Facility to Home/Self Care or Any Other Site of Care) (AMA-PCPI)

Percentage of patients, regardless of age, discharged from an inpatient facility (e.g., hospital inpatient or observation, skilled nursing facility, or rehabilitation facility) to home or any other site of care, or their caregiver(s), who received a transition record (and with whom a review of all included information was documented) at the time of discharge including, at a minimum, all of the specified elements.

0648: Timely transmission of transition record (discharges from an inpatient facility to home/self care or any other site of care) (AMA-PCPI)

Percentage of patients, regardless of age, discharged from an inpatient facility (e.g., hospital inpatient or observation, skilled nursing facility, or rehabilitation facility) to home or any other site of care for whom a transition record was transmitted to the facility or primary physician or other health care professional designated for follow-up care within 24 hours of discharge.

0649: Transition record with specified elements received by discharged patients (emergency department discharges to ambulatory care [home/self care] or home health care) (AMA-PCPI)

Percentage of patients, regardless of age, discharged from an emergency department (ED) to ambulatory care or home health care, or their caregiver(s), who received a transition record at the time of ED discharge including, at a minimum, all of the specified elements.

Topics: Navigation & Care Coordination, Patient Outcomes

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