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Updates On Current Panels


Technical Expert Panels: Established TEPs

This page serves as the designated site for information related to an established (current and past) technical expert panel (TEP). After the TEP has been established, TEPs will post membership lists, meeting agendas, and summary reports here.

 

List of Established TEPs:

Project Title: MACRA Episode-Based Cost Measures

Dates:

  • The TEP met on December 14, 2018.
  • Acumen convened a standing TEP which was recruited for four in-person meetings in August and December 2016, August 2017, and May 2018, and two webinars in March 2017 and November 2018. The Call for Nominations periods for the first two in-person meetings closed on July 5, 2016 and November 16, 2016, respectively. Subsequent TEP meetings have consisted of members recruited in the 2016 Call for Nominations period.

Documents:

The TEP Composition (Membership) List and TEP Summary are posted below in the download section.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has contracted with Acumen, LLC to develop care episode and patient condition groups for use in cost measures to meet the requirements of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The contract name is “MACRA Episode Groups and Cost Measures.” The contract number is HHSM-500-2013-13002I, Task Order HHSM-500-T0002. As part of the development and maintenance processes, Acumen, LLC convenes groups of stakeholders and experts who contribute direction and thoughtful input during development of episode-based cost measures.

Project Objectives:

The project’s overall objective is to develop episode-based cost measures for potential future use in the Quality Payment Program. Specific to this TEP, the objectives were to gather input on:

  • Approaches to development of chronic condition episode groups
  • Prioritization of chronic condition episode groups for development

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Project Title: Development of Outpatient Outcome Measures for the Merit-based Incentive Payment System (MIPS)

Dates:

The Call for Technical Expert Panel (TEP) nomination period closed on June 16, 2017.

The TEP met on July 20, 2017; September 18, 2017; February 9, 2018; September 27, 2018; and December 19, 2018.

Documents:

The TEP Membership List and TEP Summary are posted below in the download section.

Project Overview:

CMS is developing quality measures to assess the quality of care provided by clinicians who are eligible to participate in the MIPS (hereinafter, MIPS eligible clinicians). The measures will assess each eligible clinician’s outcome rate (e.g., inpatient admissions, emergency department [ED] visits, and/or observation stay rates) relative to that of other MIPS eligible clinicians with similar patients. The measures will be risk-adjusted for patient complexity, unlike other measures currently applied at the eligible clinician or group level. The quality measure scores will be calculated using patient characteristics and outcomes documented on routinely submitted Medicare claims; therefore, the clinicians whose performance will be assessed by the quality measures will not need to submit any additional data directly to CMS. The TEP is providing input to help shape the approach to the measures, such as which types of admissions should be counted in the measures.

CORE is completing this work under contract to CMS. The contract name is Measure & Instrument Development and Support (MIDS): Development, Reevaluation, and Implementation of Outpatient Outcome/Efficiency Measures. The contract number is HHSM-500-2013-13018I.

As part of its measure development process, CMS asks measure developers to convene groups of stakeholders and experts who contribute direction and thoughtful input to the measure developer during measure development and maintenance.

Project Objectives:

The primary goal of this project is to gather expert and stakeholder input to inform quality measure development and reevaluation for patients with acute or chronic conditions. CMS will use the measures to evaluate the quality of care provided by MIPS eligible clinicians.

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Project Title: Development of a Heart Failure Outpatient Outcome Measure for the Merit-based Incentive Payment System (MIPS)

Dates:

The Call for the Clinician Committee nomination period closed on October 19, 2018.

The Clinician Committee met on January 11, 2019 and February 27, 2019.

Documents:

The Clinician Committee Membership List and Clinician Committee Summary Report are posted below in the downloads section.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has contracted with Yale New Haven Health Services Corporation - Center for Outcomes Research and Evaluation (CORE) to develop outpatient outcome measures that can be used to assess the quality of care provided by clinicians who are eligible to participate in the Merit-based Incentive Payment System (MIPS).

As part of this project, CORE is developing a measure focused on care provided for patients with heart failure (hereinafter, MIPS heart failure measure). The measure will be risk-adjusted for patient complexity. The quality measure scores will be calculated using patient characteristics and outcomes documented on routinely submitted Medicare claims; therefore, the clinicians whose performance will be assessed by the quality measure will not need to submit any additional data directly to CMS.

As part of its measure development process, CORE convenes groups of stakeholders and experts who contribute direction and thoughtful input during measure development and maintenance. CORE has convened a Clinician Committee composed of front-line clinicians from rural and/or underserved communities, professional/specialty society representatives, as well as other clinicians caring for patients with heart failure. The Clinician Committee is providing input to help shape the approach to the measure, such as which types of outcomes should be counted in the measure.

The contract name is Measure & Instrument Development and Support (MIDS): Development, Reevaluation, and Implementation of Outpatient Outcome/Efficiency Measures. The contract number is HHSM-500-2013-13018I.

Project Objectives:

The primary goal of this project is to gather expert and stakeholder input to inform quality measure development of an outpatient outcome measure for patients with heart failure. CMS will use the measure to evaluate the quality of care provided by MIPS eligible clinicians.

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Project Title: Development of an Outpatient Outcome Measure of Short-term Diabetes Complications for the Merit-based Incentive Payment System (MIPS)

Dates:

The Call for the Clinician Committee nomination period closed on October 19, 2018.

The Clinician Committee met on December 10, 2018 and February 28, 2019. 

Documents:

The Clinician Committee Membership List and Clinician Committee Summary Report are posted below in the download section.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has contracted with Yale New Haven Health Services Corporation - Center for Outcomes Research and Evaluation (CORE) to develop outpatient outcome measures that can be used to assess the quality of care provided by clinicians who are eligible to participate in the Merit-based Incentive Payment System (MIPS).

As part of this project, CORE is developing a measure focused on care provided for patients with diabetes (hereinafter, MIPS diabetes measure). The MIPS diabetes measure will assess short-term complications among a cohort of patients with diabetes. The measure will be risk-adjusted for patient complexity. The quality measure scores will be calculated using patient characteristics and outcomes documented on routinely submitted Medicare claims; therefore, the clinicians whose performance will be assessed by the quality measure will not need to submit any additional data directly to CMS.

As part of its measure development process, CORE convenes groups of stakeholders and experts who contribute direction and thoughtful input during measure development and maintenance. CORE convened a Clinician Committee composed of front-line clinicians from rural and/or underserved communities, professional/specialty society representatives, as well as other clinicians caring for patients with diabetes. The Clinician Committee is providing input to help shape the approach to the measures, such as which types of outcomes should be counted in the measure.

The contract name is Measure & Instrument Development and Support (MIDS): Development, Reevaluation, and Implementation of Outpatient Outcome/Efficiency Measures. The contract number is HHSM-500-2013-13018I.

Project Objectives:

The primary goal of this project is to gather expert and stakeholder input to inform quality measure development of an outpatient outcome measure for patients with diabetes. CMS will use the measure to evaluate the quality of care provided by MIPS eligible clinicians.

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Project Title: Maintenance of Nursing Home Quality Measures 

Dates:

The Call for TEP nomination period closed on March 28th, 2019.

Documents:

The TEP Membership List is posted below in the downloads section.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has contracted with RTI International to develop and maintain quality measures for nursing homes based on the Minimum Data Set 3.0. The contract name is Development and Maintenance of Symptom Management Measures. The contract number is HHSM-500-2013-13015I. As part of its measure development process, CMS asks measure developers to convene groups of stakeholders and experts who contribute direction and thoughtful input to the measure developer during measure development and maintenance.

Project Objectives:

  • Review the following nursing home quality measures.
    • Percent of Residents with a Urinary Tract Infection (Long Stay) (NQF #0685)
    • Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder (Long Stay) (NQF #0686)
  • Inform the direction and development of the above-referenced measures.

TEP Requirements:

We sought a TEP of approximately 10-12 individuals with differing perspectives and areas of expertise, such as:

  • Policies and clinical practices in skilled nursing facilities and nursing homes
  • Pain management in older adults and nursing homes
  • Genitourinary health and care in older adults and nursing homes
  • Consumer/patient/family (caregiver) perspective
  • Healthcare disparities
  • Performance measurement
  • Quality improvement
  • Purchaser perspective

TEP Expected Time Commitment:

  • The TEP will meet once for a web-based meeting on May 23, 2019.

The TEP will receive written materials summarizing recent literature and data analyses prior to the meeting and will be asked to provide brief opinions in response prior to the meeting via email or a web-based form. The TEP may be asked to provide brief opinions in response to the meeting discussion after the meeting via email or a web-based form.

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Project Title: 2019 Merit-based Incentive Payment System (MIPS) Improvement Activities (IA) Technical Expert Panel (TEP)

Date:

The Call for TEP nomination period closed on April 26, 2019.

The TEP meeting is planned for June 26, 2019.

Documents:

The TEP Membership List is posted below in the download section.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has contracted with General Dynamics Information Technology (GDIT), through the Practice Improvement and Measures Management Support (PIMMS) – HHSM-500-2013-13008I, HHSM-500-T0001, to convene a technical expert panel (TEP) around the effectiveness and accuracy of the improvement activities (IAs) included in Year 3 of the Quality Payment Program (QPP) under the Merit-based Incentive Payment System (MIPS) Improvement Activities performance category. HealthInsight is the sub-contractor for this aspect of the project. As part of its improvement activity development process, CMS asks improvement activity developers to convene groups of stakeholders and experts who contribute direction and thoughtful input to the developer to facilitate improvement activity development and maintenance.

Project Objectives:

Comagine Health (formerly HealthInsight), through its contract with GDIT and CMS, will convene a TEP around the effectiveness and accuracy of the IAs included in Year 3 of the QPP under the MIPS Improvement Activities performance category. The TEP will perform a review of selected IAs, especially those about which the QPP Service Center has been receiving comments and questions. The purpose is to:

  • Engage users in the design of these IAs;
  • Solicit feedback on the IAs with those using them in the real world; and
  • Ensure that IAs are valid, weighted correctly, and that their qualifications/criteria make sense.

 TEP Requirements:

 We sought a TEP of approximately 10 - 12 individuals with the following perspectives and areas of expertise:

  • Subject matter/clinical expertise with IAs
  • Consumer/patient/family (non-medical caregiver) perspective
  • Healthcare disparities
  • Performance measurement
  • Quality improvement

TEP Expected Time Commitment:

The length of this meeting is approximately 120 minutes. Self-directed meeting preparation time could run approximately 4-5 hours. TEP members will be asked to complete some pre-work and review meeting materials prior to the meeting. Additionally, TEP members may be called upon to review information and provide comments after the meeting.

The TEP meeting will be conducted virtually via teleconference/virtual meeting platform. As this TEP will inform the rulemaking process, it will be conducted annually. A new TEP will be selected each year.

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Project Title: Development and Maintenance of Quality Measures for Skilled Nursing Facility Quality Reporting Program (SNF QRP)

Dates:

  • The Call for TEP nomination period closed on February 15, 2019.
  • The Technical Expert Panel will meet for a one-day, in-person meeting

Documents:

The TEP Membership List is posted below in the download section. 

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has contracted with RTI International to develop and maintain quality measures for the SNF QRP. The contract name is Development and Maintenance of Symptom Management Measures (HHSM-500-2013-13015I). As part of its measure development process, CMS asks measure developers to convene groups of stakeholders and experts who contribute direction and thoughtful input to the measure developer during measure development and maintenance.

Project Objectives:

Healthcare-associated infections are an important public health and patient safety issue. Under the Quality Priority of “Making Care Safer by Reducing Harm Caused in the Delivery of Care” is the Meaningful Measure Area of Healthcare Associated Infections. To focus on the high priority domain and fill an important gap of quality measurement in this area, this project is aimed to develop a claims-based measure of healthcare-associated infections in skilled nursing facilities.  

The purpose of this TEP is to inform the direction and development of a claims-based measure of healthcare-associated infections in skilled nursing facilities.

TEP Requirements:

We sought a TEP of approximately 10-12 individuals with the following perspectives and areas of expertise:

  • Policies and clinical practices in skilled nursing facilities and nursing homes
  • Infectious diseases
  • Consumer/patient/family perspective
  • Quality measurement science and methodology
  • Health care disparities
  • Performance measurement
  • Quality improvement
  • Purchaser perspective

 TEP Expected Time Commitment:

  • The TEP will meet once for a 1-day, in-person meeting in May 2019.
  • Input after the in-person meeting may be sought via email, as needed.
  • Follow-up meetings via webinar or telephone as needed.

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Project Title: End Stage Renal Disease (ESRD) Dialysis Facility Compare (DFC) Star Ratings Technical Expert Panel (TEP)

Dates:

  • The call for nominations period closed on April 5, 2019.
  • The first pre-TEP teleconference call will be held on May 6, 2019 at 3:00pm EDT.
  • The second pre-TEP teleconference call will be held on May 24, 2019 at 3:00pm EDT.
  • The in-person TEP meeting will be held on June 6, 2019 from 8:30am - 4:00pm EDT in Baltimore, MD

Documents:

TEP Membership List and meeting agendas are posted below in the download section.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has contracted with The University of Michigan Kidney Epidemiology and Cost Center (UM-KECC) to act as quality measure developer and DFC technical content support contractor, under the Kidney Disease Quality Measure Development, Maintenance, and Support contract. The contract number is 75FCMC18D0041, task order number 75FCMC18F0001. As part of this contract, UM-KECC convenes technical expert panels (TEPs) to provide valued consumer and provider input for both quality measure development and the Dialysis Facility Compare (DFC) Quality of Patient Care Star Rating (DFC Star Rating). This TEP Charter has been developed in response to CMS’ request for TEP recommendations related to options for resetting the DFC Star Rating baseline distribution. We are seeking interest from individuals with relevant experience, expertise, and a variety of perspectives to serve on this TEP, including patients.

A DFC Star Rating TEP was first convened in 2015 to review the original star rating methodology and presentation of the DFC Star Ratings on the DFC website. The 2015 TEP provided several recommendations that were implemented in the updated DFC Star Rating methodology released in October 2016. A second TEP was convened in 2017. TEP members provided recommendations on candidate measures proposed for inclusion in the DFC Star Ratings. See the respective 2015 and 2017 DFC Star Rating TEP reports for a summary of the deliberations and TEP recommendations. These are available at https://dialysisdata.org/content/esrd-measures.

CMS developed the DFC Star Rating to help health care consumers (including patients and caregivers) understand CMS quality measures and more easily identify differences in overall quality when selecting dialysis facilities, as part of CMS’ broader initiative for all of the Medicare Compare sites to make quality information more accessible to patients, caregivers, providers and policymakers.

The Medicare DFC website displays two star ratings: (1) the Quality of Patient Care Star Rating (DFC Star Rating) and (2) the Survey of Patients’ Experiences Star Ratings. Eleven of the DFC Quality Measures currently reported on the Medicare DFC website are used to calculate the Quality of Patient Care Star Rating (DFC Star Rating). Six In-center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH CAHPS) Survey Measures are used to calculate the separate Survey of Patients’ Experiences Star Ratings. The Survey of Patients’ Experiences Star Ratings will not be covered as a discussion topic during this TEP.

This TEP will be expected to review and provide input on options for resetting the DFC Star Ratings. This is in anticipation of the need to recalibrate the DFC Star Ratings distribution in the near future to optimize the utility of the DFC Star Ratings for patients and other consumers. Recent observed trends in national performance demonstrate progressive shifts in the DFC Star Rating results over the last three years. This may obscure underlying performance differences if many facilities become concentrated at one end of the distribution. As background, prior DFC Star Rating TEPs (referenced above) identified a strong consumer interest in the ability to follow trends in dialysis facility performance over time. In addition, TEP discussions have considered how a reporting approach, that reported longitudinal facility performance trends, could be reset from time to time if the star rating system lost the ability to show meaningful differences over the range of facility performance.

The TEP will be expected to represent a diversity of perspectives and backgrounds. Members will be selected based on their personal experience as patients, caregivers and providers, or based on methodological expertise. Given that the audience for the DFC Star Ratings is primarily patients, the TEP will have ample representation from patients and patient advocates.

We anticipate that the in-person meeting will take place over one day. There will also be additional pre- and follow-up teleconference calls. TEP members are expected to attend all meetings.

Project Objectives:

The University of Michigan Kidney Epidemiology and Cost Center (UM-KECC), through its contract with the Centers for Medicare and Medicaid Services (CMS), will convene a technical expert panel to obtain recommendations on options for resetting DFC Star Ratings distribution. Input from the TEP will inform the development of a methodology for resetting the DFC Star Ratings distribution. The final methodology developed is intended to ensure that the DFC Star Ratings to continue to be informative by reflecting meaningful performance differences among facilities.

TEP Requirements:

The TEP will be composed of 10-20 individuals with relevant expertise and perspectives, such as:

  • Renal disease patients and caregivers
  • Experts with subject matter expertise, e.g. subject-matter scientists in nephrology care; clinicians and nurses; consumer testing; communication of star rating systems in patient perspectives
  • Experts with methodological expertise, e.g. statisticians/biostatisticians with expertise in score or scale development, multivariate analysis, risk assessment, latent variable modeling
  • Individuals working on dialysis facility quality improvement
  • Individuals working on health care disparities

Potential TEP members must be aware that participation on the TEP is voluntary. As such, individuals wishing to participate on the TEP should understand that their input will be recorded in the meeting minutes. Proceedings of the TEP will be summarized in a report that is disclosed to the general public. If a participant has disclosed private, personal data by his or her own choice, then that material and those communications are not deemed to be covered by patient-provider confidentiality. If patient participants (only) wish to keep their names confidential, that request can be accommodated. Any questions about confidentiality will be answered by the TEP organizers.

All potential TEP members must disclose any current and past activities that may pose a potential conflict of interest for performing the tasks required of the TEP. All potential TEP members should be able to commit to the anticipated time frame needed to perform the functions of the TEP.

TEP Expected Time Commitment:

  • TEP members should expect to attend one or two 2-hour teleconference calls prior to the in-person meeting
  • The in-person meeting will be held for one-day on June 6, 2019 in Baltimore, MD.
  • After the in-person meeting, additional conference calls (2 – 5 calls) may be needed

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Project Title: Practitioner Level Opioid Safety Technical Expert Panel (TEP)

Dates:

  • The call for nominations opened on February 15 and closed on March 15, 2019
  • The first pre-TEP teleconference call will be held on May 1, 2019 at 12:00pm ET.
  • The second pre-TEP teleconference call will be held on May 6, 2019 at 4:00pm ET.
  • The in-person TEP meeting will be held on May 14, 2019 from 8:30am - 5:00pm ET (Baltimore, MD).

Documents:

The TEP Membership List and meeting agendas are posted below in the download section.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has contracted with the University of Michigan Kidney Epidemiology and Cost Center to develop practitioner level measures in the area of opioid safety for dialysis patients. The contract name is Kidney Disease Quality Measure Development, Maintenance, and Support. The contract number is 75FCMC18D0041, task order number 75FCMC18F0001. As part of its measure development process, CMS asks measure developers to convene groups of stakeholders and experts who contribute direction and thoughtful input to the measure developer during measure development and maintenance.

Project Objectives:

The opioid epidemic has received considerable attention over the past few years. Recent reports from the Substance Abuse and Mental Health Services Administration indicate that over 11 million Americans misuse prescription opioids (SAMHSA 2017). In the ESRD population, chronic opioid use has been associated with increased emergency department visits, hospitalizations, and increased mortality (Kimmel, JASN, 2017, USRDS, 2017).   Among ESRD patients, even small doses of opioids can lead to a substantial increase in adverse outcomes (Ishida, CJASN, 2018). ESRD patients are frequently prescribed opioids and yet are particularly susceptible to opioid related complications due to associated comorbidity and frailty, as well as to potential accumulation of opioids and their metabolites which are normally cleared by functioning kidneys.

Medication related problems from opioids can be related to suboptimal communication between providers, a lack of detailed medication reconciliation by dialysis facilities as well as a lack of understanding by providers of the effect of opiates on outcomes in dialysis patients. Addressing the misuse of opioid prescriptions thus has the potential to reduce hospitalizations, improve quality of life, and use health care resources more efficiently. Due to the frequent contact between treating ESRD Medicare Capitated Payment (MCP) practitioners, dialysis facilities’ Interdisciplinary Care Team (IDT) members and patients an increased oversight of opioid medications, even when prescribed by other providers, represents an opportunity to improve quality of care by minimizing adverse events. This TEP will evaluate the appropriateness of a measure to assess the effectiveness of the dialysis facility Interdisciplinary Team’s medication reconciliation and MCP practitioner management activities by measuring the percentage of patients who are receiving potent narcotic analgesics at high doses for prolonged periods of time. The target population will be Medicare-eligible chronic dialysis patients with Medicare Part D benefits. The provider focus will primarily be ESRD MCP providers. In addition, the TEP will consider whether a dialysis facility level measure should also be considered for development. Further, the TEP will consider and recommend appropriate risk adjustment strategies and exclusions for the measure (or measures) recommended for further development.

TEP input will be a critical component of this measure’s development. We anticipate use of a TEP whose composition includes nephrology trained pharmacists, pain-management experts, pharmacy informatics experts, patients, nephrologists, and dialysis facility nursing staff. The TEP’s discussion will provide an opportunity to evaluate the fundamental construct and validity of this measure given the novelty of evaluation of opioid prescribing practices in the context of dialysis Interdisciplinary Team medication reconciliation, medication management, and pain assessment activities.

TEP Requirements:

A TEP of approximately 13-15 individuals will make recommendations regarding practitioner level measures in the area of opioid safety for dialysis patients. The TEP will be composed of individuals with differing areas of expertise and perspectives, such as:

  • Subject Matter Expertise: nephrology trained pharmacists, pain-management experts, pharmacy informatics experts, patients, nephrologists, and dialysis facility nursing staff.
  • Consumer/patient/family (caregiver) perspective
  • Performance measurement
  • Quality improvement
  • Purchaser perspective
  • Healthcare disparities

Potential TEP members must be aware that participation on the TEP is voluntary. As such, individuals wishing to participate on the TEP should understand that their input will be recorded in the meeting minutes. Proceedings of the TEP will be summarized in a report that is disclosed to the general public. If a participant has disclosed private, personal data by his or her own choice, then that material and those communications are not deemed to be covered by patient-provider confidentiality. If potential patient participants wish to keep their names confidential, that request can be accommodated. Any questions about confidentiality will be answered by UM-KECC.

All potential TEP members must disclose any significant financial interest or other relationships that may influence their perceptions or judgment. It is unethical to conceal (or fail to disclose) conflicts of interest. However, the disclosure requirement is not intended to prevent individuals with particular perspectives or strong points of view from serving on the TEP. The intent of full disclosure is to inform the measure developer, other TEP members, and CMS about the source of TEP members’ perspectives and how that might affect discussions or recommendations.

Patient Nominees:

UM-KECC is seeking patients to participate on a TEP. We are seeking patients with kidney disease who are currently on dialysis or have received dialysis in the past to join the TEP. Patients with kidney disease can provide unique and essential input on quality measures based on their own experience and perspective.

Patient nominees should submit a completed and signed TEP Nomination Form and letter of interest as described below but are not required to submit a curriculum vitae.

TEP Expected Time Commitment:

  • TEP members should expect to come together for one to two (1 – 2 hour) teleconference calls prior to the in-person meeting held May 2019, in Baltimore, MD
  • One one-day in-person meeting (May 2019)
  • After the in-person meeting, additional conference calls may be needed

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Project Title: Palliative Care Measures Project

Dates:

Call for TEP nomination period closed on January 14, 2019.

Documents:

The TEP Membership List is posted below in the download section.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has contracted with the American Academy of Hospice and Palliative Medicine (AAHPM) as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) to develop patient reported outcome performance measures, in the areas of pain and symptom management and communication, for patients with serious illness (including those receiving palliative care). The cooperative agreement name is the “Palliative Care Measures Project.” The cooperative agreement number is 1V1CMS331639-01-00. Under this MACRA cooperative agreement, AAHPM is working to advance clinical quality measure development for palliative care patients with serious illness through the engagement of stakeholders such as measure development technical experts, clinicians, clinical specialty societies, patient advocacy groups, patients/families/caregivers, healthcare systems and others. A Technical Expert Clinical User Patient Panel (TECUPP) was established instead of the traditional TEP to be inclusive of a broader range of stakeholders in the measure development process.

Project Objectives:

  • Develop, test and implement at minimum two (2) patient reported outcome performance measures (PRO-PMs) for patients with serious illness while incorporating the patient voice and patient preferences.
  • Develop cross-cutting measures broadly applicable to patients with serious illness and their families receiving care in palliative, primary or specialty care settings in order to ultimately improve the quality of that care.
  • Convene an innovative technical expert panel that incorporates patient, caregiver, and family input directly into the measure development, specification, testing and implementation processes.
  • Submit palliative care measures for endorsement by the National Quality Forum (NQF) and for inclusion into CMS’ Quality Payment Programs (QPP) including the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).

TEP Requirements:

Thirty individuals were selected through a nomination process who represent differing perspectives and areas of expertise as listed below.

Subject matter expertise:

  • Consumer/patient/family (caregiver) perspective
  • Palliative Care
  • Healthcare disparities
  • Performance measurement
  • Quality improvement
  • Purchaser perspective

TEP Expected Time Commitment:

  • March 26, 2019, Virtual/Web Orientation Meeting (TECUPP/MSP)
  • April 10, 2019, In-Person Meeting (TECUPP)
  • April 11, 2019, In-Person Meeting (MSP)
  • Others, TBD

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Project Title: Hospital Quality Star Ratings on Hospital Compare

Dates:

The Call for TEP nomination period closed on January 30, 2017.

The TEP met on June 8, 2017; March 9, 2018; August 23, 2018; and December 12, 2018.

Documents:

The TEP Membership List and TEP Summary are posted below in the download section.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has contracted with Yale New Haven Health Services Corporation – Center for Outcomes Research and Evaluation (CORE) and Lantana, Inc. for the development and maintenance of the publicly reported Star Ratings. The CORE contract name is Development, Reevaluation, and Implementation of Outcome/Efficiency Measures for Hospital and Eligible Clinicians, Option Period 5; contract number HHSM-500-2013-13018I, Task Order HHSM-500-T0001, and the Lantana contract is called MIDS III Hospital Compare Support Contract (HCSC); contract number 75FCMC18D0029/75FCMC18F0001. As part of the development and maintenance processes, CORE and HCSC convenes groups of stakeholders and experts who contribute direction and thoughtful input during methodology refinement and maintenance.

Project Objectives:

The primary goal of the TEP is to support the evolution of the Overall Star Ratings methodology. This approach is consistent with CMS’s approach for iterative improvement of quality measures and quality programs. The Star Rating project is designed to create a picture of current measures publicly reported on Hospital Compare so that these aspects of quality are presented in a meaningful and accessible way to patients and consumers. The TEP is encouraged to provide input on any or all considerations of Star Ratings as part of its deliberations. TEP recommendations and discussion will inform the refinement of the methodology.

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Project Title: Impact Assessment of CMS Quality and Efficiency Measures

Dates:

The Call for TEP nomination period closed on November 2, 2018.

Documents:

The TEP Membership List is posted below in the download section.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has contracted with Health Services Advisory Group, Inc. (HSAG) to conduct a triennial assessment of the quality and efficiency impact of endorsed measures used in Medicare programs and report the findings to the public in the National Impact Assessment of CMS Quality Measures Report (Impact Assessment Report). The contract name is the Measure & Instrument Development and Support (MIDS) Contract. The contract number is HHSM-500-2013-13007I; HHSM-500-T0002. As part of the assessment process, HSAG is convening a group of stakeholders and experts to contribute direction and thoughtful input on the development of the fourth triennial report, scheduled for release in 2021.

Project Objectives:

  • Assess the quality and efficiency impacts of the use of measures in CMS reporting programs.
  • Inform CMS, patients, providers, researchers, quality improvement entities, measure developers, and federal partners on progress toward achieving goals and objectives related to the CMS healthcare quality priorities expressed in the Meaningful Measures framework.
  • Inform policy on measure development, selection, implementation, removal, alignment, and gaps.
  • Build infrastructure/methods to support CMS efforts to assess impact.

TEP Requirements:

We sought a TEP of 15 to 20 individuals with differing perspectives and areas of expertise, such as:

Subject Matter Expertise:

  • Patient/family/caregiver perspectives
  • Consumer and patient advocacy
  • Social risk factors and disparities
  • Health care quality improvement and clinical expertise in various settings (e.g., long-term care, acute care, ambulatory care, hospice)
  • Quality measure development and evaluation, including statistical methods and survey design
  • Health care economics and policy

TEP Expected Time Commitment:

A two-day joint meeting of the Technical Expert Panel (TEP) and the Federal Assessment Steering Committee (FASC) will be held in early May 2019 in Baltimore, Maryland.

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Project Title: Inpatient Psychiatric Facility (IPF) Outcome and Process Measure Development and Maintenance

Dates:

The Call for TEP nomination period closed on January 20, 2017.

The TEP Charter was revised to extend the TEP through February 15, 2019 and was ratified on May 30, 2018.

The TEP Meeting was held November 14, 2018.

Documents:

The TEP Meeting Summary for the November 14, 2018 meeting and the TEP Composition (Membership List) are posted below in the download section.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has contracted with Health Services Advisory Group, Inc. (HSAG), to develop, maintain, reevaluate, and support the implementation of quality outcome and process measures for the CMS Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program under the Measure & Instrument Development and Support (MIDS) Contract (Contract #: HHSM-500-2013-13007I), and Task Order Inpatient Psychiatric Facility Outcome and Process Measure Development and Maintenance (Task Order #: HHSM-500-T0004). As part of its measure development process, CMS asks measure developers to convene groups of stakeholders and experts who contribute direction and thoughtful input to the measure developer during measure development and maintenance.

Project Objectives:

This project directly supports CMS and the overall mission of the IPFQR Program by developing and maintaining measures that fill important measurement gaps and that are evidence-based, scientifically acceptable (reliable and valid), feasible, and usable by CMS, providers, and the public.

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Project Title: Development, Reevaluation, and Implementation of Outpatient Outcome/Efficiency Measures – STEMI eCQM

Dates:

The call for TEP nomination period closed on Friday, November 10, 2017. The first TEP meeting was convened on Tuesday, August 21, 2018.

Documents:

The STEMI eCQM TEP membership list and meeting #1 summary memo are posted below in the download section.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has contracted with Yale New Haven Health Services Corporation Center for Outcomes Research and Evaluation (CORE) and its partner, the Lewin Group (Lewin), to develop an electronic clinical quality measure (eCQM) that assesses the percentage of patients that received appropriate treatment for ST-segment elevation myocardial infarctions (STEMIs) in the emergency department (ED). The contract name is Development, Reevaluation, and Implementation of Outpatient Outcome/Efficiency Measures. The contract number is HHSM-500-2013-13018I. As part of its measure development process, CMS asks measure developers to convene groups of stakeholders and experts who contribute direction and thoughtful input to the measure developer during measure development and maintenance.

Per Version 14.0 of CMS’s MMS Blueprint for the CMS Measures Management System, electronic clinical quality measures (eCQMs) are based on information readily available in electronic health records (EHR) in a structured format and can be readily accessed without affecting facility workflow. The electronic specification of the measure will ensure that all data elements used to calculate the measure’s performance score can be captured in the EHR.

Project Objectives:

The project’s primary objectives, as they relate to this TEP, include:

  • Respecification of OP-2 (Fibrinolytic Therapy Received within 30 Minutes of ED Arrival) as an eCQM, including:
    • Electronic specification;
    • Testing of feasibility, validity, and effectiveness; and,
    • Recommending improvements as needed.

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Project Title: Development, Reevaluation, and Implementation of Outpatient Outcome/Efficiency Measures - Imaging Efficiency Measures

Dates:

The call for TEP nomination period closed on April 1, 2015. The first TEP meeting was convened on Friday, June 5, 2015. The second TEP meeting was convened on Friday, September 11, 2015. The third TEP meeting was convened on Friday, February 26, 2016. The fourth TEP meeting was convened on Wednesday, August 31, 2016. The fifth TEP meeting was convened on Thursday, September 14, 2017. The sixth TEP meeting was convened on Friday, August 24, 2018.

Documents:

The imaging efficiency TEP membership list and meeting #6 summary memo are posted below in the download section.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has contracted with Yale New Haven Health Services Corporation Center for Outcomes Research and Evaluation (CORE) and its partner, the Lewin Group (Lewin), to maintain imaging efficiency measures for CMS’s Hospital Outpatient Quality Reporting (HOQR) Program, in alignment with the CMS Meaningful Measures framework objectives. The contract name is Development, Reevaluation, and Implementation of Outpatient Outcome/Efficiency Measures. The contract number is HHSM-500-2013-13018I. As part of its measure development process, CMS asks measure developers to convene groups of stakeholders and experts who contribute direction and thoughtful input to the measure developer during measure development and maintenance.

The intent of the imaging efficiency measures is to promote high-quality, efficient care in the area of imaging. Specifically, each measure aims to reduce unnecessary exposure to testing or treatment that risk downstream patient harm, ensure adherence to evidence-based medicine and practice guidelines, and promote efficiency by reducing waste.

Project Objectives:

The project’s primary objectives, as they relate to this TEP, include:

  • Reevaluating previously developed hospital outpatient imaging efficiency (OIE) measures currently in the Hospital Outpatient Quality Reporting (HOQR) Program by CMS. This includes monitoring each measure’s validity and effectiveness and recommending improvements as needed. Previously developed measures include:
    • OP-8: MRI Lumbar Spine for Low Back Pain
    • OP-9: Mammography Follow Up Rates
    • OP-10: Abdomen Computed Tomography (CT)—Use of Contrast Material
    • OP-11: Thorax CT—Use of Contrast Materials
    • OP-13: Cardiac Imaging for Preoperative Risk Assessment for Non-Cardiac, Low-Risk Surgery
    • OP-14: Simultaneous Use of Brain CT and Sinus CT

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Technical Expert Panels

Currently Accepting Nominations

Downloads:

MACRA Episode-Based Cost Measures [ZIP]

Development of Outpatient Outcome Measures for the Merit-based Incentive Payment System (MIPS) [ZIP]

Development of a Heart Failure Outpatient Outcome Measure for the Merit-based Incentive Payment System (MIPS) [ZIP]

Development of an Outpatient Outcome Measure of Short-term Diabetes Complications for the Merit-based Incentive Payment System (MIPS) [ZIP]

Maintenance of Nursing Home Quality Measures Membership List [PDF]

2019 Merit-based Incentive Payment System (MIPS) Improvement Activities (IA) Technical Expert Panel (TEP) Membership List [PDF]

Development and Maintenance of Quality Measures for Skilled Nursing Facility Quality Reporting Program (SNF QRP) Membership List [PDF]

End Stage Renal Disease (ESRD) Dialysis Facility Compare (DFC) Star Ratings Technical Expert Panel (TEP) [ZIP]

Practitioner Level Opioid Safety Technical Expert Panel (TEP) [ZIP]

Palliative Care Measures AAHPM Composition Membership List [PDF]

Hospital Quality Star Ratings on Hospital Compare Technical Expert Panel [ZIP]

Impact Assessment of CMS Qualityand Efficiency Measures - TEP Membership Composition List [PDF]

Inpatient Psychiatric Facility (IPF) Outcome and Process Measure Development and Maintenance [ZIP]

Development, Reevaluation, and Implementation of Outpatient Outcome/Efficiency Measures – STEMI eCQM [ZIP]

Development, Reevaluation, and Implementation of Outpatient Outcome/Efficiency Measures - Imaging Efficiency Measures [ZIP]