Neurology Endorsement Maintenance 

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The Opportunity

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. Specifically:

• Strokes were the fourth leading cause of death in the United States in 2009, as well as a leading cause of disability.¹ Each year, approximately 795,000 people suffer a stroke.² Health care costs for stroke-related morbidity reached $73.7 billion in 2010.³
• An estimated 5.4 million Americans have Alzheimer’s disease, and an estimated 16 million will have Alzheimer’s by 2050.⁴ The disease accounts for 70 percent of the cases of dementia in the country.⁵ In 2009, Alzheimer’s disease was the fifth leading cause of death for adults ages 65 and over. Medicare and Medicaid spending on people with Alzheimer’s disease totaled $130 billion in 2011; this could rise to $1.1 trillion by 2050.⁶
• Epilepsy affects two million Americans and is estimated to cost $15.5 billion each year in medical costs and lost or reduced earnings and production.⁷
• One million Americans have Parkinson’s disease, and the combined direct and indirect costs are estimated at $25 billion per year.⁸
• Approximately 400,000 Americans have multiple sclerosis.⁹
• Traumatic brain injury (TBI) is a major health issue affecting all age groups in the United States, causing 52,000 deaths and 275,000 hospitalizations each year. An additional 1.3 million people are treated for mild TBI and released annually from emergency departments. Direct and indirect costs for treatment and lost productivity add up to an estimated $76.5 billion yearly. These numbers do not include TBI associated with serving overseas in the military.¹⁰

NQF has endorsed a number of consensus standards to evaluate the quality of care for neurological conditions over the past decade. As quality measurement has matured, better data systems have become available, electronic health records are closer to widespread adoption, and the demand for meaningful performance measures has prompted development of more sophisticated measures of healthcare processes and outcomes for neurological conditions. An evaluation of the NQF-endorsed® neurology measures and consideration of new measures will ensure the currency of NQF’s portfolio of voluntary consensus standards.

About the Project

This project began in March 2012.

Objectives

To ensure the currency of NQF’s portfolio of voluntary consensus standards for neurology, both newly submitted measures and consensus standards for maintenance review will undergo the consensus development process together, including review against the most recent NQF evaluation criteria. In addition to ensuring currency of specifications and evidence for the focus of the measure, endorsement maintenance provides the opportunity to harmonize specifications and to ensure that an endorsed measure represents the “best in class.”

NQF is seeking performance measures that could be used for accountability and public reporting in the following topic areas related to neurology for adults and children in all settings of care. Measures including treatments, diagnostic studies, interventions, or procedures associated with these conditions will be considered:

• Stroke and transient ischemic events;
• Cognitive impairment and dementia (including Alzheimer’s disease);
• Headache (including migraine);
• Epilepsy and related disorders;
• Parkinson’s disease
• Multiple Sclerosis and other demyelinating diseases;
• Movement disorders;
• Disorders of consciousness;
• Spinal cord disorders;
• Brain injuries;
• Other disorders of the nervous system.

NQF Process

The candidate measures will be considered for NQF endorsement as voluntary consensus standards. Agreement around the recommendations will be developed through NQF’s formal Consensus Development Process (CDP, Version 1.9). This project will involve the active participation of representatives from across the spectrum of healthcare stakeholders and will be guided by a multiple-stakeholder Steering Committee.

Funding

This project is supported under a contract provided by the Department of Health and Human Services.

Related NQF Work

• Stroke Prevention and Management, 2008: https://www.qualityforum.org/Projects/Stroke_Prevention_and_Management/Stroke_Prevention_and_Management.aspx
• Ambulatory Care Using Clinically Enriched Administrative Data, 2008: https://www.qualityforum.org/projects/ambulatory_clinically_enriched_data.aspx
• Patient Outcomes – Mental Health, 2010: https://www.qualityforum.org/projects/Patient_Outcome_Measures_Phase3.aspx
• Patient Safety Measures: https://www.qualityforum.org/projects/patient_safety_measures.aspx

Contact Information

For further information, contact Karen Johnson, MS, or Suzanne Theberge, MPH, at 202-783-1300 or via email at neurology@qualityforum.org.

Footnotes:

1. Centers for Disease Control. Available at www.cdc.gov/nchs/fastats/stroke.htm. American Stroke Association. Available at www.strokeassociation.org/STROKEORG/AboutStroke/About-Stroke_UCM_308529_SubHomePage.jsp. Last accessed February 2012.
2. The Internet Stroke Center. Available at www.strokecenter.org/patients/about-stroke/stroke-statistics/. Last accessed February 2012. 
3. American Stroke Association. Available at www.strokeassociation.org/STROKEORG/AboutStroke/Impact-of-Stroke_UCM_310728_Article.jsp. Last accessed February 2012.
4. Centers for Disease Control. Available at www.cdc.gov/mentalhealth/data_stats/alzheimers.htm. Last accessed February 2012.
5. BrightFocus Foundation. Available at http://www.brightfocus.org/alzheimers/about/understanding/facts.html. Last accessed March 2013.
6. Centers for Disease Control. Available at http://www.cdc.gov/aging/aginginfo/alzheimers.htm. Last accessed February 2012.
   Alzheimer’s Association. Available at www.alz.org/documents_custom/2011_Facts_Figures_Fact_Sheet.pdf. Last accessed February 2012.
7. Centers for Disease Control. Available at www.cdc.gov/epilepsy/basics/fast_facts.htm. Last accessed February 2012.
8. Parkinson’s Disease Foundation. Available at www.pdf.org/en/parkinson_statistics. Last accessed February 2012.
9. National Multiple Sclerosis Society.  Available at www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/faqs-about-ms/index.aspx#howmany. Last accessed February 2012.
10. Centers for Disease Control. Available at www.cdc.gov/mmwr/preview/mmwrhtml/ss6005a1.htm?s_cid=ss6005a1_w. Last accessed February 2012.
    Centers for Disease Control. Available at www.cdc.gov/traumaticbraininjury/statistics.html. Last accessed February 2012.