Measure development update

July 2018 – Vol. 37, No. 6

One of the goals of AAO-HNSF is to promote quality through the development of meaningful measures that enhance the care and practice of medicine for ear, nose, throat, and related structures of the head and neck. With that goal in mind, seven Clinical Advisory Committees (CACs) were established by the Reg-entSM Executive Committee (REC) in the fall of 2016 to prioritize the topics for measure development and to identify current best evidence across the breadth of the specialty, which includes facial plastics, general ENT and sleep, head and neck, hearing and balance, voice and swallowing, pediatrics, and sinus and allergy. 

To advance the established prioritization of topics, AAO-HNSF initiated five projects for measures development between June 2017 and November 2017, as outlined below:

  1. Age-Related Hearing Loss (ARHL). These measures were prioritized as an important public health issue by the REC and CACs for measures development. A cross-specialty, multidisciplinary panel convened in June 2017 for the development of de novo measures for this prioritized topic.
  2. Project Jumpstart Measures. These measures were developed utilizing key action statements from existing AAO-HNSF clinical practice guidelines (CPGs). With CPGs on otitis media with effusion, Bell’s palsy, voice outcomes after thyroid surgery, and tympanostomy tubes, the CACs and the REC approved a process to prioritize the key action statements of our CPGs as measures concepts for the specialty. An otolaryngology-specific panel convened in June 2017 for the development of CPG measures.
  3. ECRI Pilot Measures. AAO-HNSF entered into a pilot with the ECRI Institute for development of measures utilizing ECRI’s GEM-cutting software, which develops e-specified measures from guideline action statements. Measures were developed for the AAO-HNSF allergic rhinitis and cerumen impaction CPGs through this process.
  4. AAO-HNSF/AAN. Using the AAO-HNSF 2017 CPG: Benign Paroxysmal Positional Vertigo, AAO-HNSF and the American Academy of Neurology partnered for the development of neurotology measures.
  5. AAO-HNSF/ASPS/AAFPRS. AAO-HNSF is currently partnering with the American Society of Plastic Surgeons and the American Academy of Facial Plastic and Reconstructive Surgery to develop rhinoplasty measures based on the AAO-HNSF 2017 CPG: Improving Nasal Form and Function after Rhinoplasty.

Meaningful measures

Last fall the Centers for Medicare & Medicaid Services (CMS) announced the “Meaningful Measure” initiative intended to prioritize and streamline quality measurement. CMS has defined 19 measure areas that relate one of six quality priorities:

  • Promote effective communication and coordination of care
  • Promote effective prevention and treatment of chronic disease
  • Work with communities to promote best practices of healthy living
  • Make care affordable
  • Make care safer by reducing harm caused in the delivery of care
  • Strengthen person and family engagement as partners in their care

What does this mean for AAO-HNSF?

Measures developed by AAO-HNSF are used for multiple reasons, not solely for CMS reporting. By the end of 2018, AAO-HNSF will have developed over 30 otolaryngology-head and neck surgery-specific measures that include patient-centered care, best practice, and safe and efficient care. Moving forward, we will continue to blend the needs of the profession, the desires of the patients, and the requests from payers into meaningful measures for you and your patients.

The measures for otitis media with effusion, cerumen impaction, age-related hearing loss, allergic rhinitis, Bell’s palsy, postoperative laryngeal examination for dysphonia, and tympanostomy tubes were submitted with our Reg-ent Qualified Clinical Data Registry to the Centers for Medicare & Medicaid Services (CMS) on November 1, 2017, for use in Reg-ent in 2018.

For the 2018 measurement period, 19 out of 24 AAO-HNSF-developed measures were provisionally approved by CMS for utilization by our members in Merit-based Incentive Payment System reporting.

In October, CAC members will convene at the AAO-HNSF 2018 Annual Meeting & OTO Experience in Atlanta, Georgia, to continue ongoing discussion of measure development priorities and the importance of developing meaningful quality measures for each otolaryngology specialty. For a full list of available 2018 Reg-ent measures, see below or visit: www.entnet.org/2018-measures. For questions regarding measures development, contact: measures@entnet.org.