The documents on this page provide summaries of NQF's recent measure endorsement projects. They'll give you quick context and topline details, including settings where measures can be used, and a list of the endorsed measures.
Many infectious diseases have been controlled or eradicated through the use of vaccines and advanced medicine, yet many others are still responsible for widespread morbidity and mortality as well as rising healthcare costs. Specifically, hospital charges for infectious disease averaged $96 billion per year with an average 4.5 million hospital days per year in 2008. In 2012, total federal spending on HIV/AIDS-related medical care, research, prevention, and other activities was $21.3 billion. And the healthcare system spends $17 billion on sexually transmitted infection each year. NQF has now endorsed 16 measures focused on screening and treatment for infectious diseases.
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Neurological conditions and injuries affect millions of Americans each year, taking a tremendous toll on patients, families, and caregivers, and costing billions of dollars in treatment, rehabilitation, and lost or reduced earnings. NQF has endorsed 19 measures addressing neurological care, including measures focused on stroke treatment as well as imaging and care for dementia and epilepsy.
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Americans are exposed to more preventable medical errors than patients in other industrialized nations, costing the United States close to $29 billion per year in healthcare expenses, lost worker productivity, and disability. These costs are passed on in a number of ways, including insurance premiums, taxes, or lost work wages. NQF has endorsed 30 measures related to complications in healthcare.
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Cancer – defined by the National Institutes of Health as a group of more than 100 diseases characterized by uncontrolled cellular growth, proliferation, and spread – has an enormous impact on the United States. The American Cancer Society has estimated that cancer was responsible for close to 570,000 deaths among adult and children in 2010, and that half of all men and more than one-third of all women will develop cancer at some point in their lifetimes. In October 2012, NQF endorsed 38 measures focused on a range of cancers and care concerns, including hematology and melanoma; oncology; prostate and lung cancers; breast and colon cancers; and palliative care.
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Behavioral health refers to a state of mental or emotional being and choices and actions that affect wellness, as defined by the Substance Abuse Mental Health Services Administration (SAMHSA). Behavioral health problems include substance abuse and misuse, alcohol and drug addiction, serious psychological distress, suicide, and mental and substance abuse disorders. In November 2012, NQF endorsed 10 measures focused on behavioral health.
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Population health is generally understood as a systems-level concept that describes health outcomes of a group of individuals. Population health not only focuses on disease across multiple sectors, but also health and well-being, prevention and health promotion, and disparities in such outcomes and improvement activities within groups. In October 2012, NQF endorsed five healthy lifestyle behavior and broader population-level measures, including those that can assess social, economic, and environmental determinants of health and outcomes.
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Care coordination is a multifaceted concept referring to the need for meaningful communication and cooperation among providers as patients move through the healthcare system’s many facilities and care settings – hospitals, doctor’s offices, nursing homes, and people’s own homes. In August 2012, NQF endorsed 12 care coordination measures for accountability and quality improvement.
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Research from the Institute of Medicine shows that racial and ethnic minorities often receive lower quality care than their white counterparts, even after controlling for factors such as insurance coverage, socioeconomic status, and comorbidities. In August 2012, NQF endorsed 12 measures designed to help advance quality improvement efforts and eliminate disparities across the healthcare community.
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As the third leading cause of death in the United States, chronic lung disease affects close to 33 million Americans. NQF has endorsed 22 measures related to pulmonary conditions and the critical care setting, which focus on treatment processes and outcomes for asthma, chronic obstructive pulmonary disease (COPD), and pneumonia.
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Six months into 2012, NQF has completed 12 measure endorsement projects, resulting in 177 endorsed measures and two measurement frameworks. The newly endorsed measures address several critical areas of care, focusing on patient outcomes, underserved populations, people with multiple chronic conditions, and known gaps in performance measurement. With the help of more than 200 dedicated steering committee volunteers, a highly engaged NQF membership, and an array of both experienced and new measure developers, NQF's progress in building and maintaining its best in class measure portfolio is evident.
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In recent years, the nation has increased its attention on improving population health through the promotion of preventive care screening for specific cancers, osteoporosis and other disease and/or conditions. In May 2012, NQF endorsed 19 measures that address influenza and pneumococcal immunizations across many healthcare settings, as well as screenings for specific cancers, sexually transmitted diseases, and osteoporosis.
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The number of surgical procedures, especially those performed outside of hospitals, continues to rise each year. In 2006, 99 million surgeries were performed in the United States, with 53 million of those taking place in ambulatory surgery centers. In May 2012, NQF completed work on the surgery endorsement maintenance 2010 project, endorsing 51 measures on surgical care performed in hospitals and outpatient facilities.
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People with multiple chronic conditions (MCCs) now comprise over one-quarter of the U.S. population. This population is at significantly higher risk of adverse outcomes and complications. They are also more likely to see multiple clinicians, take five or more medications, and receive care that is fragmented, incomplete, inefficient, and ineffective. Despite the growing prevalence of MCCs and associated complications, existing quality measures largely do not address individuals with MCCs. As a result, in May 2012, NQF endorsed a measurement framework for these individuals.
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About one in five Medicare beneficiaries that leave a hospital are readmitted within 30 days. Such unplanned readmissions – many of which have the potential to be prevented – cost Medicare about $15 billion annually. The private sector also spends billions of dollars each year on people who end up back in the hospital within a month of an initial stay. In April 2012, NQF endorsed two all-cause unplanned readmissions measures.
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With an estimated four million babies born in the United States annually, pregnancy and childbirth related procedures account for all five of the most common medical procedures for women of childbearing age. Conditions related to pregnancy, childbirth, and newborns also account for nearly a quarter of hospitalizations each year. In April 2012, NQF endorsed 14 measures related to perinatal care, focusing on childbirth, pregnancy and post-partum care, and newborn care.
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An estimated 31 million adults in the United States suffer from chronic kidney disease, making renal-related diseases one of the leading causes of morbidity and mortality. Often brought on by existing conditions such as cardiovascular disease, diabetes, hypertension, and obesity, chronic kidney disease accounted for close to 25 percent of all Medicare expenditures in 2008. In April 2012, NQF endorsed 12 measures addressing a range of renal-related conditions and treatments.
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Estimates show that by 2030, there will be 72 million older people in the United States. Accordingly, the healthcare community has increasingly focused its attention on the quality and availability of palliative and end-of-life care services. In February 2012, NQF endorsed 14 measures addressing palliative and end-of-life care delivery, helping ensure older adults and acutely ill patients receive the high-quality care they deserve.
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As health reform efforts focus on expanding coverage, increasing access to care, and reducing costs, understanding how resources are being used is important. For the first time ever, NQF has endorsed eight measures related to healthcare resource use and costs, which can help create a more efficient, less wasteful healthcare system.
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Heart disease is the leading cause of death for men and women in the United States and was estimated to cost the United States $316.4 billion in 2010. In January 2012, NQF endorsed 39 cardiovascular measures – with an increased focus on outcomes and composite measures – designed to address cardiovascular conditions in all settings of care.
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Preventing healthcare-associated infections (HAIs) has become a national priority for public health and patient safety. In January 2012, NQF endorsed four HAI measures for use across a range of care settings, including a newly harmonized surgical site infection measure from the CDC and American College of Surgeons.
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Regional coordination has been identified as a critical means of improving emergency medical care through more efficient resource use. In January 2012, NQF endorsed a framework that establishes a roadmap for systematically regionalizing emergency care services at the national, state, and regional level.
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