NQF/HHS Population Health Framework Project: Overview. May 19, Nancy Wilson, MD, MPH, BSN Agency for Healthcare Research and Quality

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1 NQF/HHS Population Health Framework Project: Overview May 19, 2015 Nancy Wilson, MD, MPH, BSN Agency for Healthcare Research and Quality Allen Leavens, MD, MPH National Quality Forum

2 National Quality Strategy Established by the Affordable Care Act to improve the delivery of health care services, patient health outcomes, and population health The Strategy was first published in 2011 and serves as a nationwide effort to improve health and health care across America The Strategy is iteratively designed by public and private stakeholders and provides an opportunity to align quality measures and quality improvement activities 2

3 The Relationship Between the IHI Triple Aim and NQS Three Aims 3

4 The NQS: How It Works Improving health and health care quality can occur only if all sectors, individuals, family members, payers, providers, employers, and communities, make it their mission. Members of the health care community can align to the National Quality Strategy by doing the following: Use one or more of the nine levers to identify core business functions, resources, and/or actions that may serve as means for achieving improved health and health care quality. Focus on the six priorities to guide efforts to improve health and health care quality. Adopt the three aims to provide better, more affordable care for the individual and the community. 4

5 The National Quality Forum The National Quality Forum (NQF) is a not-for-profit, membership-based organization focused on catalyzing improvements in health and healthcare. NQF activities include: Convening groups working to foster quality improvement in both public- and private-sectors. Endorsing consensus standards for performance measurement. Promoting public availability of consistent, high-quality information and opportunities to provide feedback on performance measure use. 5

6 NQF s current and recent work on Population Health Aligned with NQS Three-Part Aim Focus beyond medical model increased emphasis on determinants of health and improvement activities Population Health Community Action Guide Address measurement, measure gaps, methodological and other challenges of population health measure development Opportunity to leverage population health activities and to exchange ideas between committees Health and Well-being Endorsement Measurement MAP Family of Population Health Measures 6

7 NQF s Health and Well Being Measure Endorsement Informed by a commissioned paper from Jacobson and Teutsch*, which included: An environmental scan of efforts to measure and improve population health; Guidance for measuring total population health, determinants of health, and health improvement activities; Emphasis on alignment of clinical care and public health systems; Methodological challenges of population health measurement. * D. Jacobson and S. Teutsch. An Environmental Scan of Integrated Approaches for Defining and Measuring Total Population Health

8 MAP Family of Measures for Population Health Selection of Measures by the MAP Population Health Task Force NQF Portfolio Leading Health Indicators County Health Rankings Measures MAP Population Health Family of Measures 8

9 Population Health Framework Project BASE YEAR OPTION YEAR ONE OPTION YEAR TWO CRITERIA for Selecting Conceptual Frameworks CRITERIA for Selecting Field Testing Groups ENVIRONMENTAL SCAN of National, State and Local Conceptual Frameworks FIELD TESTING GROUPS for Implementation Input to refine the Draft Action Guide FIELD TESTING GROUPS for Implementation Input to finalize the Action Guide Action Guide 1.0 Action Guide 2.0 Final Action Guide 3.0

10 Population Health Framework Committee Kaye Bender, PhD, RN, FAAN (Co-Chair) Public Health Accreditation Board, Alexandria, VA Bruce Siegel, MD, MPH (Co-Chair) America's Essential Hospitals, Washington, DC Shikha Anand, MD, MPH National Initiative for Children's Healthcare Quality, Boston, MA Catherine M. Baase, MD Dow Chemical Company, Midland, MI Georges C. Benjamin, MD, FACP, FACEP American Public Health Association, Washington, DC Christina Bethell, PhD, MBA, MPH Child and Adolescent Health Measurement Initiative, Portland, OR Kevin L. Bowman, MD, MBA, MPH WellPoint, Inc., Baltimore, MD Debra L. Burns, MA Minnesota Department of Health, St. Paul, MN Beverly Franklin-Thompson, PharmD, MBA GlaxoSmithKline, Piney Flats, TN Reneé Frazier, MHSA, FACHE Healthy Memphis Common Table, Memphis, TN Rahul Gupta, MD, MPH, FACP Kanawha-Charleston and Putnam Health Departments, Charleston, WV Shelley B. Hirshberg, MA Formerly of P2 Collaborative of Western New York, Williamsville, NY Paul E. Jarris, MD, MBA Association of State and Territorial Health Officials, Arlington, VA Keith C. Kosel, PhD, MHSA, MBA VHA Inc., Irving, TX Jeffrey Levi, PhD Trust for America s Health, Washington, DC Doris Lotz, MD, MPH New Hampshire Department of Health and Human Services, Concord, NH J. Lloyd Michener, MD Duke University Medical Center, Durham, NC Doriane C. Miller, MD Center for Community Health and Vitality of the University of Chicago Medical Center, Chicago, IL David B. Nash, MD, MBA Thomas Jefferson University, Philadelphia, PA David Stevens, MD, FAAFP George Washington University, Washington, DC Matthew Stiefel, MS, MPA Kaiser Permanente, Oakland, CA Steven M. Teutsch, MD, MPH UCLA Fielding School of Public Health, Los Angeles, CA Julie Trocchio, RN, MS Catholic Health Association of the United States, Washington, DC 10

11 The Population Health Action Guide Purpose: Support individuals and groups working together at all levels local, state and national in a sustained effort to improve population health over time The Action Guide includes: Definitions of key terms Ten elements important for making lasting improvements in population health Ideas/recommendations for actions to take Examples of measures, tools, and other practical resources 11

12 Action Guide: Ten Elements A self-assessment about readiness to engage in this work Leadership across the region and within organizations An organizational planning and priority-setting process A community health needs assessment and asset mapping process An agreed-upon, prioritized set of health improvement activities Selection and use of measures and performance targets Audience-specific strategic communication Joint reporting on progress toward achieving intended results Indications of scalability A plan for sustainability 12

13 Testing the Action Guide During the past year, the first version of the Action Guide was field tested by ten groups across the country who are working on improving the health of their communities Feedback from these groups is helping to inform the next version of the Action Guide A significant emphasis is also being placed on characterizing the measures that the various groups are using in their initiatives 13

14 Next Steps Version 2.0 of the Action Guide will be released this summer The measures being used in the field will be mapped to broader domains, with the intent of identifying areas of alignment and potential gaps We continue to invite broader stakeholder input on various issues raised in the Action Guide 14

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