Health Care Vision 2020

Aligning Forces for Quality

Performance Measurement / Public Reporting Work Group

Charters

Overall purpose:  To develop and implement a plan for publicly reporting West Michigan physician performance in caring for persons with chronic conditions.

Reports to:  Governance Board

Charge:

• Review the planning phase work plan supplied to the work group and recommend any desired and appropriate modifications to the plan.
• Develop, for governance board action, a work plan covering the implementation phase of the work group’s activities and responsibilities.
• Conduct research, including use of RWJ technical expertise and review of current/historical performance reporting efforts in West Michigan, regarding performance metrics and public report formats that are meaningful to consumers/patients.
• Develop public report formats and content.
• Develop, in conjunction with the Consumer Engagement Work Group:
  • Educational/instructional content regarding how to use the reports, including definitions and examples of “quality”.
  • An awareness building campaign to publicize the reports’ existence and value
  • Report distribution strategies to maximize the numbers of consumers exposed to the reports.
• Oversee and guide the development and dissemination of public performance reports created under the auspices of this initiative.
• Recommend to the Performance Measurement Work Group additional performance indicators and types of information of high value to consumers—for future expansion of the performance measure sets.
• Respond to queries from the Performance Measurement Work Group regarding what performance metrics are of interest and value to consumers.
• Participate in the design and conduct of the initiative’s evaluation as appropriate.
• Other activities that may arise during the course of this initiative relevant to the interest and expertise of the work group.

Overall purpose:  To develop and implement a system for measuring  physician ambulatory care performance regarding care of persons with  chronic conditions and to ensure transparency regarding all measurement activity carried out under the auspices of the initiative.

Reports to:  Governance Board

Charge:

• Review the planning phase work plan supplied to the work group and recommend any desired and appropriate modifications to the plan.
• Develop, for governance board action, a work plan covering the implementation phase of the work group’s activities and responsibilities.

• Recommend diseases/chronic conditions that will be the initial focus of measurement and reporting, as well as a sequence for expanding on the initial set of conditions over time—with a rationale (criteria satisfied) for the recommendations.
• Develop criteria for acceptable performance measures and recommend the specific metrics by which physician performance will be assessed, taking into account national measurement sets, current measurement activity already being undertaken within W. Michigan, technical expertise supplied by RWJ, feasibility at the local level.  This activity includes the establishment of measure definitions and calculation methodologies.
• Identify sources for the data required to apply the recommended performance metrics, including but not limited to claims data and medical record/EMR data.
• Guide the development data agreements with suppliers of data covering use of the data and other appropriate agreement parameters—for approval by the AFH Board.
• Develop the procedures for merging data from multiple sources into a merged data base.
• Develop policies and procedures governing the appropriate management of data, including but not limited to security and access issues.
• Develop rules, policies and procedures for ensuring that the data from which performance is calculated meet agreed upon criteria for accuracy, reliability, completeness and related parameters.
• Develop a process for vetting measure results with affected physicians prior to preparation of public performance reports.
• Oversee the application of innovative data analysis techniques (e.g., artificial intelligence tools and methods) intended to extend understanding of physician performance.
• Oversee and guide the ongoing operations of data collection and analysis  (calculation of metrics) carried out by the initiative.
• Act as a technical resource to other work groups, including analysis and response regarding physician performance metrics and related topics asked about or suggested by the Public Reporting Work Group or the Consumer Engagement Work Group.
• Establish and operate a process to respond to queries from physicians and others regarding data reliability, veracity of measures, and other technical issues related to data and performance metrics.
• Participate in the design and conduct of the initiative’s evaluation  as appropriate.
• Other activities that may arise during the course of this initiative relevant to the interest and expertise of the work group.

Expectations of work group members:

• Duration of appointment—3 years
• Attendance at meetings—frequency
• Additional work