Measuring What Matters Most to Older Adults
Measuring Quality for People with Complex Needs: A New Approach
- An individual’s priorities and health goals should guide their care and the outcome measures that are used to evaluate care:
- This is a central tenet of Essential Attributes of a High-Quality System of Care for Adults with Complex Care Needs, developed by a group of national experts in aging and disability.
- Existing quality measures do not capture what is most important to individuals, particularly older adults with functional limitations and complex health issues. A new approach to measurement is needed.
NCQA and six collaborating organizations are experimenting with a new way to measure outcomes in older adults that focuses on person-driven outcomes—outcomes identified by individuals (and caregivers) as important. The six collaborating organizations include:
- CareSource (Dayton, OH)
- iCare (Milwaukee, WI)
- Priority Health (Grand Rapids, MI)
- University of California Los Angeles
- University of California San Francisco
- U.S. Medical Management (Dallas, TX and Lansing, MI)
This work aims to balance the need for individualized and meaningful goals to guide care with the need for structured, reliable data for quality measurement.
We’re testing two approaches:
- Goal attainment scaling: Measures progress toward goal attainment using defined range of expected outcomes (expected, better than expected, worse than expected).
- Person-reported outcome measurement: Assesses progress on an individualized outcome using a validated set of questions.
Initial findings suggest these approaches improve the care planning process and provide valuable data on the range of goals that are important to older adults and their caregivers. They can move us toward a more personalized approach to quality measurement for people with complex needs.
Interest in Person-Driven Outcomes
Many stakeholders have been interested in promoting Person-Driven Outcomes. NCQA has been invited to present on this work to groups that include:
- The American Geriatrics Society
- National Association of States United for Aging and Disability
- American Society on Aging
- Patient-Centered Outcomes Research Institution
- Associations of Community Health Plans
- International Society for Quality of Life Research
We are developing training materials and a digital application that can be disseminated broadly to organizations that want to use a structured approach to eliciting and monitoring progress on the unique goals of their population. Our next steps will be to create and test quality measures based on person-driven outcomes that can be incorporated into NCQA products, such as the new Long-Term Services and Supports Distinction for Health Plans and Accreditation of Case Management for Long-Term Services and Supports.
Sign up to assist in testing these quality measures today. For more information, contact Erin Giovannetti at email@example.com.
This work is funded by The John A. Hartford Foundation and The SCAN Foundation.