AAHD Involvement in National Quality Forum

The DRDC Dissemination Core, which is housed at the American Association on Health and Disabilities (AAHD), in Rockville, MD, is closely involved with supporting the National Quality Strategy and the National Quality Forum, which are both described below.

The Triple Aim of the National Quality Strategy, which was established by the Affordable Care Act is to:

  1. Improve the patient experience of care (better care)
  2. Improve the health of populations (healthy people/healthy communities)
  3. Reduce the per capita cost of health care (affordable care)

The purpose of the National Quality Forum (NQF) is to consider measures which further the national aims in the National Quality Strategy.

Clarke Ross, D.P.A., AAHD public policy director, serves as a Member of the NQF workgroup on persons dually eligible for Medicare and Medicaid (2012-present). Dr. Ross also serves as the NQF representative of the Consortium for Citizens with Disabilities (CCD) Task Force on Long Term Services and Supports. Since 2014, Dr. Ross has served as the NQF duals workgroup liaison to the NQF Post-Acute Care/Long-Term Care workgroup.

In July 2012, the Consortium for Citizens with Disabilities (CCD) Task Force on Long-Term Services and Supports, a national coalition of disability organizations of which AAHD is an active member, identified six gaps, listed below, in existing quality standards as they directly relate to persons with disabilities. These provide a context for reviewing NQF work and persons with disabilities.

  1. Consumer Choice and Participant-Directed Services
  2. Satisfaction: Individual Experience with Services and Supports
  3. % in employment or meaningful day activity
  4. % in independent housing – Consumer choice, housing appropriateness, stability
  5. Integrated primary and specialty care
  6. Access to timely and appropriate care

In 2013, and reaffirmed in 2014, 2015, & 2016, the NQF workgroup on persons dually eligible for Medicare and Medicaid stated seven High Priority Measure Gaps:

  1. Goal-directed, person-centered care planning and implementation
  2. Shared decision-making
  3. Systems to coordinate healthcare with non-medical community resources and service providers
  4. Beneficiary sense of control/autonomy/self-determination
  5. Psychosocial needs
  6. Community integration/inclusion and participation
  7. Optimal functioning (e.g., improving when possible, maintaining, managing decline)

In August 2016, the NQF workgroup on persons dually eligible for Medicare and Medicaid added two additional High Priority Measure Gaps:

  1. Home and Community-Based Services
  2. Affordable and Effective Care

Dr. Ross, on behalf of the AAHD, closely monitors the impact on persons with disabilities and shares reports on the following NQF Committees: Behavioral Health, Disparities, Persons Dually Eligible for Medicare and Medicaid, Health and Well-being, Home and Community-Based Services, MAP (Measures Application Partnership) Coordinating Committee, Medicaid – Adults, Medicaid – Children, Population Health, Person and Family-Centered Care, Post-Acute Care/Long Term Care.

Regarding patient experience/better care, AAHD, on behalf of the DRDC, closely monitors the work of and shares with the NQF the status of: National Core Indicators (for persons with intellectual and other developmental disabilities), National Core Indicators/Aging and Physical Disability, Personal Outcome Measures (for persons with intellectual and other developmental disabilities and increasingly for persons with mental illness), NIDILRR funded Westchester Institute on Disability adaptation of CAHPS (Consumer Assessment of Healthcare Providers and Systems), and the CMS-AHRQ Medicaid home and community-based services experience survey (a CAHPS instrument). We also share the lessons from the ACL funded, NCOA administered chronic disease self-management project.

Regarding population and community health, AAHD, on behalf of the DRDC, closely monitors the work and shares with the NQF federally supported initiatives such as those of the August 11 HHS Healthy People 2020 webinar on Improving Health Outcomes Through Inclusion and Participation for Persons with Disabilities – CDC NCBDDD funded 19 state NCBDDD disability & health programs; NIDILRR RRTCDD Health Matters; CDC funded NACCHO Health Promotion Program; CDC funded Montana Living with a Disability Program; CDC NCHS tracking statistics; and CDC NCBDDD supported National Center on Health, Physical Activity, and Disability (NCHPAD). We also share lessons from the CDC NCBDDD funded Inclusive Health initiative by Special Olympics, International.