PACE Quality Director's Handbook

NPA has released its first PACE Quality Director’s Handbook. The handbook is a resource for both new and experienced quality professionals within PACE organizations. The PACE Quality Director’s Handbook outlines the responsibilities of the PACE quality leader as defined by PACE regulations and is intended to assist in the development, implementation, maintenance and evaluation of a robust quality improvement program, as well as to serve as a reference for other PACE staff involved in quality improvement efforts.

NQF Webinar on Quality Measurement

On May 24 NPA hosted a webinar titled "Quality Measurement: Overview & Emerging Trends" with John Bernot, MD, vice president of Quality Measurement Initiatives at the National Quality Forum (NQF). Dr. Bernot provided an overview of the essentials of quality measurement, including the definition and types of performance measures (e.g., outcomes measures), the process for selecting measures that demonstrate and promote quality improvement, and the NQF measure endorsement system. The NQF-endorsed CMS PACE Quality Measures also were discussed. A recording of the webinar is now available. (The password is PACEquality.)

HPMS PACE Quality Monitoring Module

CMS released the updated HPMS PACE Quality Monitoring Module on April 2, combining PACE Level I and II data into PACE Quality Data.

You can access the following resources:

If you have any questions regarding the revised PACE Quality Data reporting requirements, submit an inquiry at the CMS DMAO Portal.

For more information, contact Mia Phifer, vice president of Quality at NPA.

CMS Releases HPMS PACE Quality Monitoring Module

CMS released the HPMS PACE Quality Monitoring Module on April 2, combining PACE Level I and II data, which will now be collectively known as PACE Quality Data. Effective April 2, PACE organizations must use the HPMS module to report all Quarter 2 PACE Quality Data and may no longer use the portal for these submissions. However, the portal will remain available for PACE organizations to provide responses to previously submitted PACE Level II events and to ask policy questions.

CMS hosted training on the new PACE Quality Monitoring Module and reporting requirements on March 22. Information on how to access the training via webinar is included in the HPMS email.

If you have questions related to this information, contact Mia Phifer.

CMS PACE Quality Measures

NPA Develops Final Comment Letter for CMS PACE Quality Measures – Stream 3

NPA has developed a final comment letter in response to the call for public comment on three proposed draft measures: Participant Influenza Immunization, PACE Staff Influenza Immunization, and Participant Emergency Department (ED) Utilization Without Hospitalization.

For more information, contact Mia Phifer.

Comments on CMS PACE Quality Measures – Stream 2

Nov. 30 is the deadline for submitting comments on the PACE Quality Measures – Stream 2 to the Centers for Medicare & Medicaid Services (CMS). NPA developed a comment letter in response to the call for public comment and a template letter for use in providing comments to CMS.

For more information, contact Mia Phifer.

CMS Posts Three Additional PACE Quality Measures – Stream 3

On Nov. 13 CMS posted three additional PACE quality measures (Stream 3) for public comment on the CMS Quality Measures website. The project title for these measures is "Development, Implementation, and Maintenance of Quality Measures for the Programs of All-Inclusive Care for the Elderly (PACE)." The Call for Public Comment period opens on Nov. 15, and comments are due to CMS and its contractor, Econometrica, by midnight on Dec. 15.

CMS currently is seeking comments on three additional draft quality measures for PACE:

  • Participant Influenza Immunization,
  • PACE Staff Influenza Immunization, and
  • Participant Emergency Department (ED) Utilization Without Hospitalization.

In addition to general comments on any of these measures, CMS is seeking input on several topics identified during validity testing that are related specifically to the following:

  • definition of reporting influenza season;
  • participant inclusion criteria for the denominator of the Participant Influenza measure;
  • definition of contraindications; and
  • treatment of observation stays in ED Utilization Without Hospitalization measure.

As part of its measure development process, CMS encourages interested parties to submit comments on the proposed measures and the suitability of these measures to the PACE program. Comments received will inform the final technical specifications on the third set of quality measures that CMS plans to implement for PACE programs. For additional information regarding the proposed measure specifications, data collection instructions, and specific instructions for the submission of comments for these potential measures, visit the CMS Quality Measures website.

NPA, with guidance from the Performance Measures Subcommittee of the NPA Quality Committee, will submit a comment letter to CMS and develop a template comment letter for NPA members. To further inform our comment, we encourage you to share the comments of your organization with Mia Phifer, vice president of Quality, by Dec. 1.

If you have any questions, contact Mia Phifer.

Performance Measures Ensure Accountability

The creation of performance measures for PACE programs is imperative to ensure that the programs are accountable to their participants and to demonstrate the value and quality of the PACE model of care. As the federal government and the states continue to focus on integrated care for the dually-eligible population, NPA recognizes the need to develop performance measures to monitor the provision of long-term care services for this population.

NPA is developing a core set of quality measures in collaboration with the Quality Committee. The selection criteria considered for the measures will include the following:

  • High Impact (i.e., high prevalence, high cost, national health priority area);
  • Relevance (to PACE population);
  • Feasibility (i.e., required data that are readily available or could be captured without undue burden); and
  • Usability and Use (for the purposes of quality improvement and accountability).

The performance measures will provide a way to assess the quality of health care and services against recognized standards and allow PACE programs to demonstrate value to payers and consumers and to distinguish the PACE model from similar approaches. The NPA Common Data Set project will enhance the performance measures and explore the development of robust outcome measures.

PACE Quality Leadership Program

Recognizing that PACE professionals have unique challenges and opportunities, NPA developed the Quality Leadership Mentorship Program. The program pairs experienced PACE quality improvement (QI) professionals with new quality leaders. The objective is to foster an exchange of information and experience, allowing for the transmission of guidance and support. Potential mentees can indicate their preference for a mentor from the same CMS region or from a PACE organization similar in census or any other characteristic. All mentors are volunteers working with NPA and the Quality Improvement Committee to strengthen the recognition for quality care in PACE.

Quality Improvement Symposiums

NPA offers QI professionals in PACE two annual dedicated events focused on issues related to quality improvement and compliance. For more information, visit the Education section.

QI Data Analysis and Research

In addition to actively working with the Quality Improvement Committee and CMS leadership on audit and compliance issues, NPA engages in data analysis to identify educational opportunities for QI professionals in PACE. NPA reviews the data collected through DataPACE2 for trends and opportunities to implement PACE-wide quality improvement initiatives. NPA also facilitates collaboration among the Quality Improvement, Primary Care, Research and Education committees to develop projects such as research studies and educational materials.

There are more than 120 PACE programs in 31 states. See how your demographics and service utilization compare with those of your peers.

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