Improving the Health Care Experience: Measuring What Matters to People

NCQA project to measure person-driven outcomes

June 6, 2018

WASHINGTON, DC—The National Committee for Quality Assurance (NCQA) is testing an innovative and promising approach to measuring individual outcomes for people with complex health issues. The Person-Driven Outcome Measures project, funded by The John A. Hartford Foundation and The SCAN Foundation, aims to measure quality of care by evaluating how effectively health care organizations are helping individuals achieve what matters most to them. We know that when we evaluate and reward systems for focusing on people’s personal goals, we can transform care to be truly person-centered.

This demonstration project will take place over the next three years and will include over 800 participants. NCQA will work with four geographically diverse organizations (a mix of health plans and integrated care networks) representing 30 clinicians (including social workers, nurse practitioners and registered nurses).

The four demonstration sites are:

“Most everyone agrees individuals’ priorities and health goals should guide their care,” said Margaret E. O’Kane, NCQA President. “Are people more concerned about lowering their A1C levels or walking to the corner market? Would they rather see improvement in BMI or be able to spend more time with a loved one?

“Existing quality measures do not effectively evaluate what is most important to people, particularly older adults with complex care needs and we hope to change that,” O’Kane added.

In a pilot study (also funded by The John A. Hartford Foundation and The SCAN Foundation), NCQA developed and tested an approach to collect person-driven outcomes that uses a combination of individualized and standardized person-reported outcome measures to track goals of care over time.

Individuals and providers who participated in the pilot found the person-driven outcome approach was feasible and added value to their care planning discussions. Individuals reported being more motivated to achieve their goals and providers reported learning about new goals that could help to engage individuals in their care.

This demonstration project, funded at $2.1 million, aims to more fully test these approaches across organizations and demonstrate the importance, reliability, validity and usability of quality measures derived from the use of person-driven outcomes.

“In order to achieve truly person-centered care, we have to incorporate what matters most to older adults into every health care conversation,” said Bruce Chernof, MD, president and CEO of The SCAN Foundation. “This project will show how health systems can ask what matters in a sustainable way, and the value this knowledge brings to both provider-person interactions and the overall quality of care.”

This work aligns with The SCAN Foundation’s What Matters Most: Essential Attributes of a High-Quality System of Care for Adults with Complex Care Needs primer document developed by a working group and published in September 2016. The group defined four Essential Attributes of a high-quality system of care that supports system transformation and evaluation, and is from the vantage point of adults with complex care needs.

This project strongly supports The John A. Hartford Foundation’s Age-Friendly Health Systems initiative, as well, which centers on knowing and acting on each older adult’s specific health outcome goals and care preferences, reducing healthcare-related harm, and increasing older adults’ satisfaction with their care.  The initiative, launched in 2017, is a partnership with the Institute for Healthcare Improvement, American Hospital Association, Catholic Health Association and five health systems representing more than 30 states.

“By streamlining and focusing quality measures – and all of health care – on what truly matters to older adults living with complex conditions, we can achieve better outcomes and greater value for payers, providers, and older patients and their families,” said Terry Fulmer, PhD, RN, FAAN, President, The John A. Hartford Foundation.

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