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Market-wide Adoption of Patient Reported Outcomes Measures

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Widespread adoption of patient-reported outcome measures (PROMS) is central to improving patient experience and quality, advancing value-based payment and reducing health care costs.  Impacting care redesign and payment reform requires multi-stakeholder engagement and alignment across public and private payers.  Both public and private sector payers are committing to value-based payment mechanisms such as population-based models, episodes of care and physician payment under MACRA and other CMS demonstrations.  Major suppliers, such as pharmaceutical and device manufacturers, are pledging to shift to outcomes-based contracts, but such contracts require broad availability of standardized outcomes measures.  Implementation and use of patient-reported outcomes measures in the U.S. has been limited due to administrative challenges, perceived patient burden, and lack of consensus on appropriate methods.

PBGH seeks to increase the availability of these measures for patient-centered outcomes research, quality improvement, value purchasing, outcomes-based contracting, and patient engagement.  Under the direction of a National Steering Committee, PBGH has developed a business model, work plan and a series of methodology papers that would support the measurement of health outcomes in U.S. communities (defined as a geographic market or a collaboration of multiple health systems in a market), including patient-reported outcomes across an entire population, sufficient to support improvements in patient care, value-based contracting and payment.  Two implementation projects are underway to collect oncology PROMs and depression screening and remission at six months. The goal is to catalyze the transformation of the healthcare system by measuring and promoting high quality, high value care in key clinical areas through multi-purchaser, multi-stakeholder collaboration.

Support for this initiative comes from the Gordon and Betty Moore Foundation, Robert Wood Johnson Foundation and industry.

PBGH has also engaged in federal policy discussions to support the integration of PROMs in Medicare payment reform and care redesign initiatives.  Read more about the potential use of PROMs under CMS Payment Policy and in the Oncology Care First model .

In September 2018, the Centers for Medicare & Medicaid Services (CMS) awarded PBGH a Cooperative Agreement (CMS-1V1-18-002) to develop and test patient-reported outcome-performance measures (PRO-PMs) for oncology care that will expand measures for use in the Quality Payment Program. The aims for this three-year project are to enhance patient-centered cancer quality measurement by 1) developing and testing patient-reported outcome-performance measures (PRO-PMs) regarding health-related quality of life (HRQoL) and pain for patients with breast, colon and lung cancer, and 2) preparing documentation for successful submission of the measures to National Quality Forum and CMS. By engaging community physicians, leading cancer specialty centers, patients, and other stakeholders to select cross-cutting patient-reported outcomes measures, the initiative will identify performance elements that are most meaningful and feasible for patients and their doctors, and ultimately improve quality and patient experience. Additionally, parallel work is underway to develop a fatigue measure for this population.  Read more.

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For additional information, contact Rachel Brodie at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .