Aparna Higgins Explains Significance of AHIP's Core Quality Measures

Aparna Higgins, senior vice president of Private Market Innovations and Center for Policy and Research at America’s Health Insurance Plans (AHIP), explained that CMS and AHIP’s recent release of core quality measures was an effort to help harmonize the varying types of measures that already exist as well as to focus in on quality improvement efforts.

Transcript (slightly modified)

CMS and AHIP recently released sets of core quality measures. What is the importance of this effort?

There’s a lot of variability in the measures that are being used in public as well as private programs and variability in measures across these programs. And, we had done some work to look at that, had published a paper, sort of looking at that variability a little bit more systematically and I think it makes it difficult for clinicians to focus their quality improvement efforts when they’re being ask to report and being measured on lots of different measures.

And so I think what this helps do is to help focus quality improvement efforts, really helps focus efforts on measures that are evidence-based, that are high value and help drive quality improvement and ultimately, patient outcomes.

How difficult can it be for providers and hospitals to provide high-quality care when there is not a core set of measures to guide them?

When there’s a lot of fragmentation and variability in the measures that are being asked of clinicians, that again translates into fragmentation variability in their efforts within their practice to improve care for their patients because one payer might be asking them to focus on A1C control greater than 9 and CMS may be asking them to do something different. I think part of it is it makes their improvement efforts a lot more challenging and it increases the burden.

And so, I think this was an effort to try to get harmonization, help reduce the burden and focus on improving efforts. I do want to clarify that our core measures were focused on ambulatory care measurement.