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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: Development of Meaningful Clinical Quality Measures for Mental Health and Substance Use Disorders

Dates:

The Call for TEP nomination period closed on January 16, 2019.

The TEP met on June 3, 2019.

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 provided funding to The American Psychiatric Association (APA) to develop meaningful quality measures that fill CMS-designated high priority areas, including mental health and substance use disorders. The cooperative agreement name is MACRA Measure Development for the Quality Payment Program Mental Health/Substance Use Care. The cooperative agreement number is 1V1CMS331640-01-01. As part of its measure development process, APA convenes groups of stakeholders and experts who contribute direction and thoughtful input to the measure developer during measure development and maintenance.

Project Objectives:

The APA Initiative to Develop Meaningful Behavioral Health Quality Measures will aim to form scientifically sound quality measures that will improve processes and outcomes for those treated for mental and substance use disorders. This includes three measure domains:

  1. Measurement-based care (MBC), or the systematic use of standardized tools (i.e., tools consumers use to report symptoms, functioning, and recovery; and clinician-rated outcome measurement tools for symptoms, where indicated) to support initial assessment, continuous monitoring, shared care planning, and patient engagement.
  2. Evidence-based treatment for patients with suicide risk, psychosis, and opioid use; and
  3. Care experience, patients’ report on the degree to which certain predefined processes (e.g., clear communication with a clinician) occurred during an episode of care.

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Project Title: Hospital Harm Electronic Clinical Quality Measures (eCQMs)

Dates:

The Call for TEP nomination period closed on January 16, 2017.

The TEP met on April 13, 2017; December 7, 2017; November 12, 2018; January 25, 2019.

Documents:

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

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) contracted with Yale New Haven Health Services Corporation – Center for Outcomes Research and Evaluation (CORE) to develop a hospital-level Electronic Health Record (EHR)-based performance measure of multiple dimensions of patient harm or adverse patient safety events that can be improved with high quality care. The contract name was Development, Reevaluation, and Implementation of Outcome/Efficiency Measures for Hospital and Eligible Clinicians, Option Period 5. The contract number was HHSM-500-2013-13018I, Task Order HHSM-500-T0001. As part of its measure development process, CORE convened groups of stakeholders and experts who contributed direction and thoughtful input to the measure developer during measure development and maintenance. This summary report was finalized and posted by IMPAQ International, the current contractor for the Patient Safety Measure Development and Maintenance contract. The current contract number is 75FCMC18D0027, Task Order 75FCMC19F0001.

Project Objectives:

The primary goal was to develop hospital-level eCQMs of multiple dimensions of patient harm that allow CMS to assess hospital performance while ensuring hospitals have access to meaningful information to enable quality improvement.

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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 TEP met on May 9, 2019.

Documents:

  • The TEP Summary Report and the TEP Membership List are 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. The contract number is HHSM-500-2013-13015I. As part of its measure development process, RTI International convenes 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.

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

Dates:

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

The TEP met on June 26, 2019.

Documents:

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

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) contracted with General Dynamics Information Technology (GDIT), through the Practice Improvement and Measures Management Support (PIMMS) contract – 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 under the Merit-based Incentive Payment System’s (MIPS) Improvement Activities performance category. Comagine Health (formerly HealthInsight) is the sub-contractor for this aspect of the project.

As part of its improvement activity development process, the contractor, GDIT, convenes groups of stakeholders and experts who contribute direction and thoughtful input during improvement activity development and maintenance.

Project Objectives:

Comagine Health, through its contract with GDIT, convened a TEP around the effectiveness and accuracy of the Improvement Activities included in Year 3 of the Quality Payment Program under the MIPS Improvement Activities performance category. The TEP performed a review of selected Improvement Activities, especially those about which the Quality Payment Program Service Center has been receiving comments and questions. The purpose was to:

  • Engage users in the design of these Improvement Activities;
  • Solicit feedback on the activities with those using them in the real world; and
  • Ensure that Improvement Activities are valid, weighted correctly, and that their qualifications/criteria are clinically relevant and not overly burdensome to the clinician.

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Project Title: Measuring Outcomes in Orthopedics Routinely (MOOR)

Dates:

The Call for TEP nomination period closed on February 17, 2019.

The TEP met on April 25, 2019 in Boston, Massachusetts. The meeting lasted one full day.

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 provided funding to Brigham and Women’s Hospital (BWH) to develop and refine electronic clinical quality measures (eCQMs) in the areas of orthopedic surgery outcomes and medication safety, and to develop and refine a Patient Reported Outcome Performance Measure (PRO-PM) related to orthopedic surgery clinical care. The cooperative agreement name is Measuring Outcomes in Orthopedics Routinely (MOOR). The cooperative agreement number is 1V1CMS331637-01-00. As part of its measure development process, Brigham and Women’s Hospital convenes groups of stakeholders and experts who contribute direction and thoughtful input to the measure developer during measure development and maintenance.

Project Objectives:

To ensure alignment with CMS’s Quality Payment Program (QPP), specifically the Merit-based Incentive Payment System (MIPS), the objectives of the MOOR project are as follows:

1) Convert two existing National Quality Foundation (NQF) approved measures for complication following Total Hip Arthroplasty and Total Knee Arthroplasty (THA/TKA) to electronic clinical quality measures (eCQMs):

a) Risk-standardized complication rate (RSCR) following elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA)

b) Opioids in high dosage in persons without cancer following elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA)

2) Develop three new eCQMs to address THA/TKA orthopedic surgery patient safety practice and measurement gaps:

a) Opioid extended use rate following elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA)

b) Risk-standardized opioid-related respiratory depression rate following elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA)

c) Risk-standardized bleeding-related adverse drug event rate for patients taking anticoagulant medications following elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA)

3) Develop a new PRO-PM:

a) Care goal achievement following total hip arthroplasty (THA) and/or total knee arthroplasty (TKA).

4) Explore the anticipated efficacy, costs, and benefits of our proposed eCQMs and PRO-PMs to our study population (i.e., Medicare fee for service beneficiaries undergoing elective procedures). In the process of developing and refining eCQMs and PRO-PMs, use existing electronic data to automate workflow and to minimize burden of the measures we develop.

5) Brigham and Women’s Hospital is collaborating with Massachusetts Health Quality Partners (MHQP), a stakeholder engagement organization, and with Brigham and Women’s Hospital Department of Orthopedic Surgery specialty physicians and the Partners Healthcare Patient Reported Outcomes Measurement System (PROMS) team to develop eCQMs in the areas of orthopedic surgery outcomes, medication safety, and PRO-PMs related to orthopedic surgery clinical care. The collaboration is enhanced by the mutual interests, shared by the participating organizations, that include focusing on patient engagement to improve safety and outcomes using innovative patient-centered technologies.

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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 was held on May 6, 2019 at 3:00pm EDT.
  • The second pre-TEP teleconference call was held on May 24, 2019 at 3:00pm EDT.
  • The in-person TEP meeting was held on June 6, 2019 from 8:30am - 4:00pm EDT in Baltimore, MD
  • The post-TEP teleconference call is scheduled for August 21, 2019 at 1pm-3pm EDT

Documents:

TEP Membership List and meeting agenda 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:

UM-KECC sought a TEP of approximately 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

See the membership list in the Downloads section for a final list of participants.

TEP Expected Time Commitment:

  • TEP members should expect to attend one or two 2-hour teleconference calls prior to the in-person meeting
  • One one-day in-person meeting 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: Maintenance of Nursing Home Quality Measures

Dates:

The Call for TEP nomination period closed on March 28, 2019. The TEP met for a web-based meeting on May 23, 2019.

Documents:

The TEP Composition (Membership) List and TEP Summary report are 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 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, RTI International convenes 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.

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Project Title: MACRA Episode-Based Cost Measures - Call for Clinical Subcommittee

Dates:

The Call for Clinical Subcommittee nomination period closed on April 12, 2019.

Documents:

The Clinical Subcommittee Membership List is 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-T00002. 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 suitable for potential use in the Quality Payment Program. For more details about the project background, including development activities undertaken in previous years, please see this MACRA cost measure development approach summary on the MACRA Feedback Page.

Acumen’s measure development approach is to convene clinician expert panels called Clinical Subcommittees (CS) focused on particular clinical areas in cycles of development (“waves”). In Wave 3 beginning in 2019, Acumen convened the following:

  • Three CS to develop procedural and acute inpatient medical condition episode based cost measures in the following clinical areas: Dermatologic Disease Management; General and Colorectal Surgery; and Hospital Medicine.
  • A new Chronic Condition and Disease Management CS to develop episode-based cost measures for chronic conditions.

Specific to these Clinical Subcommittees, the objectives are to:

  • Select which episode-based cost measure to develop and discuss measure intent
  • Provide input on the desired composition of the workgroup that will build out the selected measure.
  • In addition to these topics, the Chronic CS will also consider and provide input on the basic framework of chronic condition episode groups, including logic for opening (or “triggering”) an episode and attributing episodes to clinicians.

Clinical Subcommittee Requirements:

The four Clinical Subcommittees convened in this third wave are: Chronic Condition and Disease Management, Dermatologic Disease Management, Hospital Medicine, and General and Colorectal Surgery. Future CS under this project will be convened through separate nomination periods.

We sought nominees with various desired qualifications, such as having relevant medical credentials and having board certification or other professional certifications as applicable, and with differing perspectives and areas of expertise, such as familiarity with medical coding (ICD-10, CPT/HCPCS, DRG), experience treating Medicare patients, or previous performance measurement or quality improvement experience.

Expected Time Commitment:

  • Members of each CS are expected to review preparatory materials shared ahead of the meeting and to attend one CS meeting meet during which they will (i) recommend which episode-based cost measure to develop, and (ii) discuss the desired composition of the workgroup that will build out the selected measure. For the Dermatologic Disease Management CS and Chronic CS, this meeting will be one day-long, in-person meeting in the Washington-Baltimore metropolitan area on May 30 and 31, 2019, respectively. For the General and Colorectal Surgery CS and Hospital Medicine CS, this meeting will be one three-hour webinar on May 29 and June 3, 2019, respectively. After each Subcommittee recommends which measure(s) to develop during Wave 3, a smaller measure-specific workgroup will be formed to complete the majority of measure development.
  • Members of the measure-specific workgroup resulting from the measure selected based on input from the Clinical Subcommittees are expected to review preparatory materials shared ahead of the meeting and attend one day-long in-person meeting for selected workgroup members in Washington, DC, in August 2019, plus travel time (exact dates will be determined taking into consideration workgroup member availability).

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Project Title: Clinical and Anatomic Pathology Measure Development

Dates:

The Call for TEP nomination period closed on March 1, 2019.

Documents:

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

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has provided funding to the American Society for Clinical Pathology to develop a set of pathology-related quality measures that will be incorporated into the Quality Payment Program. The cooperative agreement name is Medicare Access and CHIP Reauthorization Act of 2015 (MACRA): Measure Development for the Quality Payment Program. The cooperative agreement number is CMS-1V1-18-002. As part of its measure development process, the American Society for Clinical Pathology convenes groups of stakeholders and experts who contribute direction and thoughtful input to the measure developer during measure development and maintenance.

Project Objectives:

  • Re-tooling of seven measures developed for the National Pathology Quality Registry.
    • Meaning to review our current measures for clinical and technical content, and update them as needed due to changes in new coding, changes in the clinical climate and/or data sources and structure.
  • Development of electronic clinical quality measure (eCQM) specifications for seven registry-based process measures.
  • Submission of seven measures to the National Quality Forum for endorsement.

TEP Requirements:

We sought a TEP of approximately 12 individuals with differing perspectives and areas of expertise in pathology and laboratory medicine, such as:

Subject Matter Expertise:

Pathology and Laboratory Medicine

Consumer/patient/family (caregiver) perspective  

Payer perspective 

Surgical Pathology 

Patient Safety 

Appropriate utilization of laboratory testing 

Laboratory Information Technology (IT) perspective  

Clinical Terminologies 

Electronic clinical quality measure standards (e.g. Health Level Seven) 

TEP Expected Time Commitment:

  • Initial 2-4-hour webinar meeting in mid-late May 2019
  • Review of pre-meeting materials and completion of an online Survey Monkey tool in advance of the meeting
  • Follow-up 2-hour webinar in August 2019 to review alpha testing results (to include all TEP members)
  • Potential 1-hour workgroup meetings between May and August 2019 (to include targeted subset of TEP members)

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Project Title: Hospital Outcome Measurement for Patients with Social Risk Factors

Dates:

The Call for TEP nomination period closed on February 25, 2018.

The TEP met on May 22, 2018 and January 17, 2019.

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) to develop methodologies for presenting disparities in hospital outcome measures. One methodology will illuminate differences in outcomes for patient groups based on social risk factors within a hospital. The other methodology will allow for comparison of performance in care for patients with social risk factors across hospitals. The contract name is Development, Re-evaluation, and Implementation of Outcome/Efficiency Measures for Hospital and Eligible Clinicians, Option Period 5. The contract number is HHSM-500-2013-13018I, Task Order HHSM-500-T0001. As part of developing these methodologies, CORE convenes groups of stakeholders and experts who contribute direction and thoughtful input during method development and maintenance.

Project Objectives:

The primary goal of this project is to develop and evaluate two methodologies to report readmission rates by patient dual eligibility status. These methodologies will serve two complementary goals: to highlight disparities in health care quality between dual and non-dual eligible patients within hospitals and to illuminate variation in health care quality for dual eligible patients across hospitals. It is anticipated that the methods presented could be used in examining disparities for additional outcome measures and other social risk factors. The aim of the TEP is to receive feedback on the proposed methodologies.

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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 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: 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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Quick Links

Technical Expert Panels

Currently Accepting Nominations

Downloads:

Development of Meaningful Clinical Quality Measures for Mental Health and Substance Use Disorders [ZIP]

Hospital Harm eCQMs [ZIP]

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

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

Measuring Outcomes in Orthopedics Routinely (MOOR) [ZIP]

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

Maintenance of Nursing Home Quality Measures [ZIP]

MACRA Episode-Based Cost Measures – Clinical Subcommittee [PDF]

Clinical and Anatomic Pathology Measure Development TEP Membership List [PDF]

Hospital Outcome Measurement for Patients with Social Risk Factors [ZIP]

MACRA Episode-Based Cost Measures [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]