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  • Washington Highlights

    AAMC Supports Appeal of Three NQF Endorsed 30-Day Episode-of-Care Payment Measures

    Len Marquez, Senior Director, Government Relations

    The AAMC April 4 joined the American Hospital Association, Federation of American Hospitals, and America’s Essential Hospitals in appealing the National Quality Forum (NQF)’s endorsement of three episode-of-care payment measures. The three payment measures - covering acute myocardial infarction, heart failure, and pneumonia – were reviewed under the NQF’s sociodemographic status (SDS) trial period, but were not adjusted for SDS in its endorsement.

    The appeal raises concerns that the NQF Expert Panel’s recommendations were not followed, that the empirical analysis was flawed, that the NQF provided insufficient guidance to the relevant committee and developers, and that the conditions for measure endorsement were not met. The Associations recommends that the NQF immediately remove the measure’s endorsement and address the concerns listed.

    The letter also states that the three measures were originally endorsed in February 2015 with the understanding that three conditions would be met: review in the SDS trial period, a one-year look back assessment, and an opportunity to address attribution related concerns. Two of the three conditions have not been met.