The Opportunity
Care coordination is a multidimensional concept that includes
effective communication among healthcare providers, patients, families, and
caregivers; safe care transitions; a longitudinal view of care that considers
the past, while monitoring present delivery of care and anticipating future
needs; and the facilitation of linkages between communities and the healthcare
system to address medical, social, educational, and other support needs that
align with patient goals. Establishing effective communication within and
across the continuum of care will help to improve the quality and
affordability of our healthcare system and is foundational to successful healthcare
systems and improved patient outcomes. According to the National Academy of
Medicine, the potential opportunity for cost savings is $240 billion, resulting
from care coordination initiatives such as patient education and the
development of new provider payment models.
People with
chronic conditions and multiple co-morbidities—and their families and
caregivers—often find it difficult to navigate our already complex healthcare
system. As this ever-growing group transitions from one care setting to
another, they are more likely to suffer the adverse effects of poorly
coordinated care. Incomplete or inaccurate transfer of information, poor
communication, and a lack of follow-up care can lead to poor outcomes, such as
medication errors. Effective communication within and across the continuum of
care will improve the quality and affordability of our healthcare system.
NQF
has undertaken several projects to provide guidance and measurement of care
coordination, including a 2006 project that yielded an endorsed definition and
framework for care coordination, a 2010 project in which 25 preferred
practices and ten performance measures were endorsed, a 2012 project in which
twelve performance measures were endorsed, and, most recently, a project
completed in 2014 in which five performance measures were endorsed.
Objectives
NQF will establish a
multi-stakeholder Standing Committee to evaluate newly submitted measures and
measures undergoing maintenance review and make recommendations for measure
endorsement. This Committee will identify and endorse new performance measures
for accountability and quality improvement that specifically address care
coordination, including measures around medical, social, educational, and
other support needs. In addition, the Committee will evaluate consensus
standards previously endorsed by NQF under the maintenance process.
NQF Process
NQF will consider measures for
endorsement as national voluntary consensus standards. Consensus on the
recommendations will be developed through NQF’s formal Consensus
Development Process (CDP, 2016). A standing committee will guide
this project, which involves the active participation of representatives from
across the spectrum of healthcare stakeholders.
Funding
This project is supported under a
contract from the U.S. Department of Health and Human Services.
For
information about the availability of auxiliary aids and services for NQF’s
federally funded projects, please visit: http://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html.
Related NQF Work
Contact
Information
For further information, contact Kathryn Streeter at
202-783-1300 or carecoordination@qualityforum.org.
Footnotes
1 IOM, Roundtable on Value &
Science-Driven health Care: The Healthcare Imperative: Lowering Costs and
Improving Outcomes: Workshop Serious Summary, Washington, DC: National
Academies Press, 2010.
2 “Reducing and Preventing Adverse
Drug Events to Decrease Hospital Costs,” 2001, U.S. Dept. of Health and Human
Services, Agency for Healthcare Research and Quality, March, 2001.
Care coordination is increasingly recognized as fundamental to the successful healthcare systems and improved patient outcomes. Poorly coordinated care regularly leads to unnecessary suffering for patients, as well as avoidable readmissions and emergency department visits, increased medical errors, and higher costs. NQF will review performance measures in the care coordination domain, including measures focused on patient experience of care, health information technology, transitions of care, and structural measures.
