Performance measurement for rural and low-volume providers

This work is intended to provide recommendations to HHS regarding performance measurement issues for rural, low-volume providers, which include Critical Access Hospitals, Rural Health Clinics, Community Health Centers, and the clinicians who serve in these types of facilities. These providers often face unique issues, such as low payment volume and scarcity of resources that make measurement difficult. The Committee will consider how to mitigate these challenges in payment incentive programs for those providers; identify which measures are most appropriate for those programs; and recommend how future development resources are best directed to address particular measurement gaps areas.

Why Now?

An estimated 10% to 28% of Americans live in rural areas, millions of whom receive care from the above-mentioned providers. The Affordable Care Act calls for several new CMS pay-for-performance programs, including the Hospital Value-Based Purchasing program and the clinician-based Value-Based Payment Modifier (VBPM). Information is needed to inform the gradual integration of facilities and clinicians paid through alternative systems and those with low case volume into these or other Federal payment incentive programs, the aim of which is to improve the quality of care for people who are served by these providers.

Project Funding

This project is funded under NQF’s contract with the 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.

Contact Information

Learn more about this project, you may contact Mitra Ghazinour at 202-783-1300 or via email ruralhealth@qualityforum.org.