TO set of policy recommendations The National Quality Assurance Committee (NCQA) emphasizes the importance of building a strong digital health infrastructure that facilitates exchange without problems, promotes the adoption of digital quality measures and maximizes the maximum potential of interoperable health data through API FHIR implementations.
NCQA is an independent non -profit organization that works to improve health quality through measurement, transparency and responsibility.
Digital quality measures
NCQA said he supported the commitment of the first Trump administration to make all the quality reports of CMS and care programs based on the value to digital quality measures (DQM) based on FHIR by 2025. However, he said that this objective was depressed, decelerating the adoption of FHIR in US medical care. A recent ASTP/ONC survey found that only a fifth of health organizations makes the data available through the API HL7 FHIR. NCQA suggests that HHS creates a clearer framework for a national digital health data ecosystem, within which all medical care participants can innovate and benefit, based on existing mandates for API FHIR, USCDI and industry innovation in data generated by patients.
To improve the quality measurement report process, the NCQA urges HHS to accelerate the adoption of an DQM report architecture. «Continuous investment in quality measures not based on FHIR could prevent progress towards the use of aggregate clinical and non -clinical data, and slow health innovation,» says the report. «The HHS should prioritize DQM, which are designed to adapt to different responsibility structures, including suppliers, ACO and health plans. This change will facilitate more precise, comprehensive and flexible reports in various medical care organizations.»
The organization also recommends that HHS accelerate the alignment with the CMS Universal Foundation in the quality and payment reports based on the value of the HHS, and also that ASTP and other federal agencies clarify how the USCDI+ quality data set will interact with the regulations. «Establishing a clear route to integrate USCDI+ data sets in regulatory frameworks will be vital to achieve the true interoperability of quality data,» the report said.
The NCQA suggested that other immediate steps that CMS could take to promote data exchange throughout the system, including the introduction of one or more metric of Medicare Advantage stars that promote the exchange of standardized data between Medicare Advantage plans, its suppliers and patient networks.
NCQA also recommends that the HHS prioritize the most effective use of the patient generated data, including the results of the person reported by the person.
Behavioral health recommendations
NCQA urp the Trump Administration to collaborate with Congress to the appropriate funds to encourage the adoption of the EHR behavior provider certified, with appropriate safeguards for the privacy of the patient and the measures to prevent fraud, waste and abuse.
He said the Trump administration should instruct HHS to finance the creation of a quality framework frame for the attention of substance use disorder, ensuring the establishment of quality standards at each level of appropriate care. Such a framework would guide patients to high quality care while facilitating the transition to care based on suppliers, NCAW said.
Proposed changes for CMMI
While NCQA said that the mission of the Centers for Innovation of Medicare and Medicaid (CMMI) firmly supports, notes that only a few CMMI initiatives have really advanced quality or have delivered substantial savings for US taxpayers. It encourages the new leadership of CMMI to break with the existing limitations and create models that prioritize integration through technology and dynamic care plans.
NCQA emphasized that CMMI models should:
• Focus on conditions and procedures with a variability of significant cost, large volumes of patients and clear opportunities to reduce complications, hospital re -entry and unnecessary use.
• It requires collaboration in the setting development models sets aimed at 6–8 clinical problem areas (for example, diabetes, congestive heart failure) and 8-10 procedures (for example, hip replacement, CABG).
• Take measures to promote the generalized adoption of the FHIR data exchange standards, as incentives for the exchange of digital health data that can train better decisions by placing the necessary information in the hands of patients and professionals.
• Adopt evidence based on EDIA based on AI to generate trust and train the patient’s choice. The plans must reflect the patient -promoted objectives and be accessible to the entire care team. By using generative AIs and deterministic rules, interventions can be customized with patient -oriented digital tools that improve the general experience.
