RALEIGH, NC — The North Carolina Institute of Medicine, partnering with the North Carolina Department of Health and Human Services, releases selected measures of health care quality for North Carolina Medicaid, along with, “Metrics to Drive Improvements in Health: A Report of the Task Force on Health Care Analytics.” The Task Force was convened to define and prioritize quality measures of health and health care, to be used by the Department as it reforms the Medicaid and NC Health Choice programs to improve the health of North Carolinians.
“We are at a transformational time in the 50-year history of Medicaid in North Carolina,” said Adam Zolotor, MD, President and Chief Executive Officer of the North Carolina Institute of Medicine. As we move towards payment for value, we must get the measures of quality right. Otherwise, we will be back to the mistakes of capitation from the 80’s. This task force defined critical priorities to assure continued improvements in care quality for Medicaid beneficiaries.”
Starting in the fall of 2016, the North Carolina Institute of Medicine worked with staff and advisors to the North Carolina Department of Health and Human Services to identify a cross-section of state stakeholders to serve on the Task Force on Health Care Analytics. Members included physicians, nurses, and other health care providers; experts in health care quality measurement and directors of quality improvement initiatives; Medicaid beneficiary and patient/family representatives; private payers; care managers; and others. The Task Force built on previous work performed by the NC Department of Health and Human Services and others to define and prioritize measures and recommend an ongoing process for the state Medicaid agency to use as it reviews and updates measures. In addition, the Task Force identified measures that align with quality measurement across types of payers, including private insurers.
“I have been thrilled to participate in this work and consider it a tribute to the Department of Health and Human Services and the North Carolina Institute of Medicine that the perspective of those who receive Medicaid services is front and center in the development of a system to serve North Carolina’s most vulnerable,” said Sam Bowman-Fuhrmann, a parent of a Medicaid beneficiary, and a participant in the Task Force.
The Task Force used the framework of the Quadruple Aim in prioritizing and organizing measures. The Quadruple Aim is a widely accepted health system performance framework that focuses on improving population health, enhancing patient experience, lowering health care costs, and improving the experience and work life of health care providers. The Quadruple Aim’s primary goal is to optimize health system performance through the simultaneous pursuit of each aim, increased quality, decreased cost, improved patient experience, and work force well-being. The Task Force addressed all four aims in developing a set of measures for Medicaid, and sought to produce a concise set of measures focused on gaps of care, implications for population health, and feasibility of major and rapid improvement.
The Task Force was chaired by Warren Newton, MD, MPH, Director of the North Carolina Area Health Education Centers; C. Annette DuBard, MD, MPH, Director of Clinical Strategy, Aledade, Inc., former Chief Health Information Officer, Community Care of North Carolina; and James C. Hunter, MD, Senior Vice President and Chief Medical Officer, Carolinas Health Care System.