Patient-Reported Outcomes Measures Oncology Technical Expert Panel Summaries

PBGH is developing Patient Reported Outcome Performance Measures (PRO-PMs) that can improve quality and person-centeredness of care for patients with breast, colon and lung cancer. Funded by a CMS Cooperative Agreement (CMS-1V1-18-002), the project seeks to fill measure gaps for PRO-PMs in the domains of health-related quality of life (HRQOL), pain and fatigue for oncology patients undergoing curative treatment. PRO-PMs that can be used for multiple diagnoses will help minimize provider burden. While practice-reported pain quantification and treatment planning are used in the Oncology Care Model (OCM) and PPS-Exempt Cancer Hospital Quality Reporting Program (PCHQR) – important gaps remain, including patient-reported outcomes on the extent to which pain interferes with activities of daily living and health-related quality of life, defined as both overall physical functioning and mental health. Research demonstrates that medical oncologists who provide curative cancer patients with the highest quality care (including medical and non-medical support services) can reduce longer-term symptom burden and thus improve patient transition into cancer survivorship.

PBGH is testing two HRQOL measures, two pain measures and one fatigue measure. Our objective is to develop at least one PRO-PM in each domain for submission to CMS and NQF. The underlying PROMs will measure:

  1. Patient Reported Health Related Quality of Life (HRQOL), with two components:
    1. Overall Physical Health Following Chemotherapy
    2. Overall Mental Health Following Chemotherapy
  2. Patient Reported Pain, with two components:
    1. Pain Intensity Following Chemotherapy
    2. Pain Interference Following Chemotherapy
  3. Patient-Reported Fatigue

PBGH has engaged a multi-stakeholder Steering Committee to oversee the project, as well as a multidisciplinary Technical Expert Panel, including patient representatives, and an ad hoc Clinical Workgroup to oversee the measure development and testing. There are several validated PROM tools that will be deployed for this project: PROMIS Global Health v1.2; Pain Intensity Scale 1a; Pain Interference Short Form 4a; and Fatigue Short Form. This work will meet the National Quality Forum (NQF) measure endorsement criteria so that the PRO-PMs can be submitted to NQF for initial review in 2021. The Seattle Cancer Care Alliance will serve as the measure steward. The 36-month workplan follows CMS’ Measure Management System Blueprint and is aligned with NQF measure development principles.

An existing collaborative project between PBGH and the Michigan Oncology Quality Consortium (MOQC) will accelerate measure testing through early adopter test sites. Additional testing sites are from the Alliance of Dedicated Cancer Centers (ADCC), members of which have deep experience in measure development and testing. Twenty MOQC practices and eight ADCC centers have committed to participate as test sites. PBGH has contracted with RAND to conduct statistical analyses to test the reliability and validity of the measures and develop the risk adjustment model.

Follow the progress of this initiative through our Technical Expert Panel Meeting Summaries.

December 20, 2018 TEP Summary 

January 8, 2019 TEP Summary 

February 19, 2019 TEP Summary 

March 19, 2019 TEP Summary

April 16, 2019 TEP Summary 

May 21, 2019 TEP Summary 

September 10, 2019 TEP Summary 

February 25, 2020 TEP Summary 

October 28, 2020 TEP Summary 

December 15, 2020 TEP Summary

Review summary and comments received during Public Comment period from January 9-29, 2020 here.

PBGH welcomes stakeholder input to inform the progress throughout this initiative. Please provide public comment here