NQF Offers Guidance on Patient-Reported Outcome Performance Measures

Jan. 2, 2022
Digital patient-reported outcome performance measures called ideal but underutilized tools in value-based care programs

With funding from the Centers for Medicare & Medicaid Services, the National Quality Forum (NQF) has published a report offering technical guidance on developing patient-reported outcome performance measures.

CMS and the nonprofit NQF have partnered for more than a decade on advancing patient-reported outcome quality measurement. The NQF Roadmap aims to provide guidance to measure developers on how to develop a digital patient-reported outcome performance measure (PRO-PM) that can be used in accountability programs.

NQF noted that elevating the patient voice through patient-reported outcomes (PROs) is critical to achieving equity, strengthening the care experience, and improving health outcomes for all. Patient-reported outcome measures (PROMs) represent the tools and instruments that are used to collect the data. PROMs can be used to collect data over time, thereby measuring changes that are occurring for patients and populations. These longitudinal uses of PROMs can form the basis for performance measures (PRO-PMs), where the information is used to hold providers and payers accountable for the outcomes they achieve for their populations, according to NQF

“Value-based quality programs implemented by CMS and other payers need rigorously developed quality measures that use the voice of the patient to evaluate care outcomes, and PRO-PMs are an ideal but underutilized tool to accomplish this goal. NQF’s report distills the knowledge and expertise from a broad range of PRO-PM stakeholders and experts to provide a set of best practices to facilitate organizations’ ability to develop and implement high quality digital PRO-PMs,” said Committee Co-Chair Sam Simon, Ph.D., director of health program improvement at Mathematica, in a statement.

NQF said the report would aid measure developers in developing digital PRO-PMs that are fully tested and ready for submission to the NQF endorsement process. PRO-PMs require using PROMs as the tool to measure how a patient's health is changing over time. It uses a PROM and implements it in a standardized cadence (e.g., every three months or before and six months after a procedure) to enable measurement of how the patient is responding to a treatment. At the population level, the information can demonstrate how groups of patients respond to a treatment, ultimately helping build evidence about what works and what doesn't and, most importantly, for whom.

“Patient-reported information about health status—such as pain, physical mobility, emotional well-being, energy and fatigue—has been routinely used in clinical trials to test the impact of medication and other treatments on improving patient health. said Dana Gelb Safran, ScD, NQF president and CEO, in a statement. “These types of measures are only now beginning to be utilized in clinical care and considered for use in performance measurement. In order to incorporate PROMs into routine practice, it is important to shift to digital data collection so these methods are being developed for scaled use.”

This is the third and final report from the first year of NQF’s Building a Roadmap From Patient-Reported Outcome Measures (PROMs) to Patient-Reported Outcome Performance Measures initiative. It builds on two previous reports from this initiative: an Environmental Scan Report describing the current state of using PROMs as the data collection instruments for performance measures, and an Interim Report for identifying the attributes of high-quality PROMs for use in digital PRO-PMs.

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