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Draft Telehealth Measures Issued by National Quality Forum

Draft Telehealth Measures Issued by National Quality Forum

Telehealth is having such a great year being implemented the National Quality Forum (NQF)  issued a report outlining a measure framework with a list of measure concepts and standards for future measurement. With  Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and MIPS quality measures being implemented and refined, the long-evolving telehealth technologies are now recognized in all states. Washington just clarified what a “home” needed to access telehealth, and Texas liberalized access to the technologies.
Comments on the draft report are due June 30.

Report Looked at Various Types

NQF reviewed four modalities of telehealth: live video, store and forward, remote patient monitoring, and mobile health.
They selected five domains to measure telehealth, similar to those being used to to craft MIPS:

Access to Care ·        Access for patient, family, and/or caregiver
·        Access for care team
·        Access to information


Financial Impact/Cost ·        Financial impact to patient, family, and/or caregiver
·        Financial impact to care team
·        Financial impact to health system or payer
·        Financial impact to society
Experience ·        Patient, family, and/or caregiver experience
·        Care team member experience
·        Community experience
Effectiveness ·        System effectiveness
·        Clinical effectiveness
·        Operational effectiveness
·        Technical effectiveness

TNQF said they’d compiled this information, along with feedback from constituents, into six key areas of measurement:

  • Timeliness of care
  • Travel
  • Actionable information
  • Added value of telehealth to evidence-based practices
  • Patient empowerment
  • Care coordination

Telehealth and MACRA

NQF is funded by the Department of Heath and Human Services (HHS)  and sees the new technologies as an opportunity to enhance quality of care while increasing access. The group points out in its report, “The statute [MACRA] requires the incorporation of telehealth in coordinating patient care and includes telehealth use in scoring for MIPS. The MIPS score determines payment adjustments to clinicians based on performance.” By statutory definition, telehealth encompasses “professional consultations, office visits, and office psychiatry services” and any additional service specified by the Secretary of HHS. Telehealth was included in the final rule in two ways:

What is Macra

  1. Expanded practice access: The use of telehealth services and data analysis for quality improvement, such as participation in remote specialty care consults or teleaudiology pilots. The weight of this subcategory in the MIPS overall score lists as “Medium.”
  2. Population management: MIPS eligible clinicians prescribing warfarin must attest that 60 percent or more of their ambulatory care patients receiving the medication are managed by one or more clinical practice IAs. One of these activities will be telehealth that involves systematic and coordinated care for rural or remote beneficiaries. The weight of this subcategory in the MIPS overall score lists as “High.”


Brad Ericson
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About Has 338 Posts

Brad Ericson, MPC, CPC, COSC, is a seasoned healthcare writer and editor. He directed publishing at AAPC for nearly 12 years and worked at Ingenix for 13 years and Aetna Health Plans prior to that. He has been writing and publishing about healthcare since 1979. He received his Bachelor's in Journalism from Idaho State University and his Master's of Professional Communication degree from Westminster College of Salt Lake City.

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