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Using Registry Data to Support National Quality Forum Endorsement of Quality Measures for Home-Based Medical Care
Gregory Foakes1, Courtney Hurt, Jamie L Lehner
1PCPI Foundation, Chicago, IL US Medical Management, Troy, MI Division of Palliative Care and Geriatric Medicine, Mongan Institute Center for Aging and Serious Illness, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA Department of Medicine, Division of Geriatric Medicine, Center for Transformative Geriatric Research, Johns Hopkins University School of Medicine, Baltimore, MD.
Abstract:
Homebound older adults receiving home-based medical care (HBMC) are high-need, high-cost patients. National Quality Forum (NQF)-endorsed quality measures for this population are lacking. The objective is to describe the reliability and validity testing of 2 new quality measures for such patients to support NQF endorsement. The authors developed 2 new clinical quality measures for HBMC: evaluation of (1) functional status and (2) cognitive function. Data from a large multistate HBMC practice in a Centers for Medicare & Medicaid Services-approved qualified clinical data registry were used to test both measures for reliability and validity. In 63 000 patient encounters, provider performance rates were 68% for evaluation of functional status and 40% for cognitive function. Reliability and validity were high for both. This article describes a replicable approach to leverage registry-type data to systematically address quality gaps for high-need, high-cost populations that will raise the profile of HBMC with measure developers and payers.
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