Core Quality Measures Collaborative
The Core Quality Measures Collaborative is a multi-stakeholder effort including the Centers for Medicare & Medicaid Services (CMS), America’s Health Insurance Plans (AHIP), the National Quality Forum (NQF) and physicians, consumers, and purchaser representatives. The Collaborative is working to bring alignment to quality measurement and reporting across payers and programs, and has released its first sets of core quality measurements:
Public Consensus ACO and PCMH Core Measure Set
Public Consensus Cardiovascular Core Measure Set
Public Consensus HIV Hep C Core Measure Set
Public Consensus OBGYN Core Measure Set
Public Consensus Orthopedic Core Measure Set
Public Consensus Medical Oncology Core Measure Set
Public Consensus Gastroentestinal Core Measure Set
The Coalition to Transform Advanced Care (C-TAC) is dedicated to the ideal that all Americans with advanced illness receive comprehensive, high-quality, person- and family-centered care that is consistent with their goals and values and honors their dignity. We will achieve this by empowering consumers, changing the health delivery system, improving public and private policies, and enhancing provider capacity.
Founded by Co-Chairs of the Board of Directors, Tom Koutsoumpas and Bill Novelli, C-TAC is a nonprofit, non-partisan organization based in Washington, D.C. and is funded by grants and the support of members. Find a list of C-TAC’s 140+ members, the C-TAC action plan, and more information on the organization here.
What is advanced illness?
Advanced illness is defined as one or more conditions becoming serious enough that general health and functioning begin to decline, curative treatment loses its effectiveness, and care becomes increasingly oriented towards comfort — this process extends to the end of life.
Health Care Payment Learning and Action Network (LAN)
Health Care Payment Learning and Action Network (LAN). APG is proud to be a participant in the LAN. The U.S. Department of Health and Human Services set a goal of tying at least 30 percent of Medicare payments to quality or value through alternative payment models by 2016 and at least 50 percent by 2018. The LAN extends those Medicare goals to the private sector and states. APG is an active member in the Population Based Payment Work Group, and here are our white papers:
America’s Physician Groups has partnered with the Council of Accountable Physician Practices (CAPP) on developing physician leadership in accountable care.
CAPP physician executives pooled their physician leadership development insights in a five-article series in Healthcare: The Journal of Delivery Science and Innovation. In the articles, the authors discuss their experiences and lessons learned in recruiting, retaining, and supporting robust physician leadership within their organizations. Key CAPP physician leaders include:
- Dr. Robert Pearl, CAPP Chairman
- Dr. Mark Klau, Southern California Permanente Medical Group
- Dr. Philip Oravetz, Ochsner Health System
- Dr. Lee Sacks, Advocate Physician Partners
- Dr. Nick Wolter, Billings Clinic
Civil Justice Association of California (CJAC)
The Civil Justice Association of California (CJAC) works aggressively in the state legislature and courts to reduce unwarranted and excessive litigation that increases business and government expenses, discourages innovation, and drives up the cost of goods and services for Californians.
Gaine Healthcare devised the “Sanator” provider registry that serves as a single electronic portal for reporting of network physicians and other providers by contracted-delegated medical groups, IPAs, FQHC clinics, health plans, and hospitals that can accomodate any and all health plan formats and processes, as well as any state/federal reporting standard for network adequacy compliance.
Integrated Healthcare Association (IHA)
Integrated Healthcare Association (IHA) has been a longtime ally in many APG activities and administrator of our annual Pay-for-Performance physician group quality measurement program. APG and IHA have recently embarked on a new partnership, with support from Brookings-Dartmouth, to implement a Partial Capitation ACO program that we believe will be a valuable part of healthcare reform.
Healthcare Information and Management Systems Society (HIMSS)
Healthcare Information and Management Systems Society (HIMSS) APG is a working partner with HIMSS on their Alternative Payment Model Infrastructure and Blockchain Technology Committees, working with other industry experts on the vital connection between clinical, administrative and electronic activities which impact the clinical decisions of an organization.
National Coalition on Healthcare (NCHC)
National Coalition on Healthcare (NCHC) is a nonpartisan, nonprofit alliance representing medical societies, businesses, unions, healthcare providers, faith-based associations, pension and health funds, insurers, and groups representing consumers, patients, minorities, and persons with disabilities. Collectively, NCHC organizations represent over 100 million Americans. The Coalition is committed to lowering costs and improving quality in healthcare. APG President and CEO Don Crane is a member of the NCHC Board of Directors.
National Committee for Quality Assurance (NCQA)
National Committee for Quality Assurance (NCQA) is a private, not-for-profit organization dedicated to improving health care quality. Since its founding in 1990, NCQA has been a central figure in driving improvement throughout the healthcare system, helping to elevate the issue of healthcare quality to the top of the national agenda. APG works closely with NCQA on the Standards of Excellence™ and participates actively on their committees for Clinical Programs, Patient-Centered Specialty Practice, and Population Health Management.
National Quality Forum (NQF)
National Quality Forum (NQF) is a nonprofit, nonpartisan, membership-based organization that works to improve healthcare quality. APG is part of the Measure Applications Partnership (MAP) Clinician Workgroup, which reviews measures under consideration for the Merit-Based Incentive Payment System (MIPS) and the Medicare Shared Saving Program (MSSP). MAP recognizes the importance of incorporating cost measures into value-based payment programs such as MIPS. MAP also looks at additional composite measures under consideration for use and removal in the programs.
Pacific Business Group on Health (PBGH)
Pacific Business Group on Health (PBGH) is a coalition of large healthcare purchasers and our ongoing partner in a number of special initiatives, including shared executive leadership of a statewide health IT initiative and of the California Quality Collaborative (CQC). APG provides PBGH physician advisory functions in performance measurement initiatives and supports their multiple efforts to recognize value beyond strict dollar costs.
Partners in Care Foundation (PICF)
Partners in Care Foundation (PICF) excels at bridging the gap between medical care and a member’s social service needs. They have deep experience providing in-home services, transition coaching and medical self-management with one common goal: eliminating the non-medical barriers that prevent a person from getting the most out of their medical care. APG members enjoy the benefits of a strong group purchasing program with PICF.
Click here to listen to a podcast featuring PICF President June Simmons talking about the impact medication has on social determinants of health.
SullivanLuallin Group is a partner on APG’s group purchasing team, whereby members enjoy the benefits of a strong group purchasing program that offers the opportunity to acquire specific products and services at special, more cost-effective rates. SullivanLuallin conducts patient surveys with scores benchmarked against our Western Region Managed Care database, and helps clients from California to Saudi Arabia implement customer service initiatives that produce immediate improvement and ongoing results.
Ventegra provides access to discounts for pharmaceutical products and services, and are the largest source for capitated medical group drug rebates. APG has selected Ventegra to be the preferred provider of such services for our members. We support ACOs with an integrated pharmacy benefit administration process.
America’s Physician Groups Consulting is a team of executives with decades of success in risk-based care delivery at leading physician organizations across the country.
Alliances and Collaborations
America’s Physician Groups form strong alliances and collaborations with industry multi-stakeholders to inform important federal and state policies, improving quality of care and health outcomes for our patients.