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By Monica E. Oss

Yesterday was the wrap to the 2020 OPEN MINDS Performance Management Institute—a week with much discussion about performance, finances, and sustainability. One theme from the discussions this week was the number of performance metrics that “matter” to any executive team – depending on the customers, the market, the service, and more. In the session, Population Health Management For The Complex Consumer Market: How To Utilize Data To Coordinate Services Across The Care Continuum, Cathy Lipton, M.D.,CMD, Optum’s National Medical Director, Institutional Programs, discussed the many perspectives of stakeholders in the field – from the Centers for Medicare & Medicaid Services (CMS) to health plans to provider organizations to consumers. Her observation: Everyone is concerned about good clinical outcomes, but the definition of what that means varies.

There are already hundreds (possibly thousands) of performance measures (see What Gets Measured Is What Gets Done: Keys To Selecting Measures For Performance Management and State Performance On Adult Medicaid Core Measures: An OPEN MINDS Reference Guide), but even more were added to the list during the last 12 months. And the measures keep changing. At the national level, CMS issued a final rule to update the Medicare Inpatient Psychiatric Facilities (IPFs) for all behavioral health hospitals and general medical psychiatric inpatient units, marking the first time that CMS has addressed medication adherence as a quality metric (see Medicare Program; FY 2020 Inpatient Psychiatric Facilities Prospective Payment System and Quality Reporting Updates). Additionally, the Joint Commission now requires accredited behavioral health organizations to adopt “measurement-based care” and developed a list of measurement-based care tools and instruments (see Joint Commission Standard Requires Behavioral Health Organizations To Use Valid Instrument To Track Progress During Treatment). Another example at the state level – the California Department of Health Care Services (DHCS) released 19 draft value-based payment (VBP) performance measures for its Medicaid (Medi-Cal) managed care program (see California Releases Proposed Medi-Cal Value-Based Payment Program Measures) and Washington State has agreed to three new measures to evaluate the state’s success in preventing runaways and shortening the time youth in custody of the Department of Children, Youth, and Families (DCYF) are missing (see Washington State DCYF Agrees To New Performance Measures On Foster Care Runaways).

How to select measures for managing organizational performance – and organizing those measures – was the focus of my session, Performance Management For The C-Suite: An Executive Briefing with Carol Clayton, general manager for population health with Relias. Applying the “balanced scorecard” model (see The How-To Of ‘Metrics-Based Management’), our team has come up with five domains of performance for health and human service organizations – payer contracting, access, consumer experience, clinical expertise, and financial sustainability.

The reason for this focus on metrics is simple – knowing your organization’s performance and managing your organization’s performance is key to developing strategy and ensuring the success of strategic initiatives. With the amount of movement in the field and the pressure to innovate, having real-time measures of performance is key to deciding what to do and how to do it.

I did want to share a question posed by an executive during the institute: “We’re developing performance measures, but we never seem to be done. How will we know when our performance dashboard development is finished?” The answer is that performance management is a process, not an event. It’s a dynamic management process. And the faster the rate of change in a market, the more performance measures and performance management will change. Each new contract, new service line, new geography, and new consumer group will cause executive teams to “re-tool” their performance management tools and processes. We’ll keep on top of the changing measures of performance and the best practices to measure them in the months ahead.

For more on the changing definitions of performance in the field, check out these resources in the OPEN MINDS Circle Library:

  1. Are You Ready For Whole-Person Care? Know The Performance Measures That Matter
  2. Does Your Organization Stack Up On Key Performance Measures?
  3. Medicaid Performance On Child Behavioral Health Quality Measures Falls Below 50% In 2018
  4. State Performance On Adult Care Of Acute & Chronic Conditions Core Measures: An OPEN MINDS Reference Guide
  5. State Performance On Child Medicaid Core Health Care Measures: An OPEN MINDS Reference Guide
  6. California Medi-Cal Value Based Payment Program Performance Measures, March 2019: Proposal For Comment
  7. CMS Awards 7 Agreements For Performance Measure Development For Medicare’s Quality Payment Program
  8. Illinois Medicaid Selects Performance Measures For Integrated Health Home Program
  9. NQTLs: A Powerful Measuring Stick For Parity Compliance
  10. CMS Deletes 18 Performance Measures From Quality & Value-Based Purchasing Programs

Read coverage from the 2020 OPEN MINDS Performance Management Institute (hashtag #OMPerformance) on social media channels and follow us @openmindscircle.


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