To make the process transparent for becoming a Chartered Value Exchange, the Scoring Form, this Guide to Scoring, and Frequent Questions are available.
This Guide gives the criteria reviewers use to score Applications to become Chartered Value Exchanges.
Note: The following principles/aspirations to use as prompts are based on recommendations of the AQA/Hospital Quality Alliance (HQA) Expansion Workgroup as well as comments from the Quality Alliance Steering Committee and many stakeholders across the country.
Question 1. Engaging purchasers, plans, providers, and consumer advocacy organizations in collaboration
Compare the collaborative membership list in Part IIA of the application to the description of each of the stakeholder groups within the community in Part I. Community descriptions should include physician groups separate from hospitals, both public and private purchasers, health plans, and consumer advocacy organizations.
Assess the extensiveness of participation of each stakeholder group. Collaboratives where a greater proportion of each stakeholder group is involved should be rated more highly.
Assess the relative proportion of the stakeholder groups participating. Is the collaborative membership heavily weighted by one group? More equivalent proportions of stakeholder group involvement should be rated more highly. Hospitals and physician practices should be considered separately.
Review who makes collaborative decisions and how they are made as described in Part IIB. Collaboratives where purchasers, plans, providers, and consumer advocates are all equally involved in decisionmaking should be rated more highly.
Question 2. Engaging health information exchanges, quality improvement organizations, and other community stakeholders
Compare the collaborative's list of stakeholder groups (other than purchasers, plans, providers, and consumer advocacy organizations) to the list within the community. Broader membership should be rated more highly.
Review how the collaborative will align or facilitate coordination with health information exchanges and quality improvement organizations in particular. More specific processes should be rated more highly.
Question 3. Obtaining or generating standard performance information
Review with whom the collaborative works or plans to work to obtain or generate information. Optimally, the information would be constructed by pooling information from all relevant community sources. Collaboratives obtaining and/or generating information from a greater proportion of community sources should be scored more highly.
Review the collaborative approach to getting nationwide principles, standards, and measures adopted and used within the community. Activity underway and greater specificity of plans should be rated more highly.
The following principles/aspirations can be used as prompts when reviewing responses:
- Seeks to obtain or generate standard performance information at the most granular and appropriate level (e.g., physician, practice site, medical group, and hospital).
- Seeks to obtain or generate standard performance information inclusive of all of the Institute of Medicine six performance domains (safe, timely, effective, efficient, equitable, patient-centered).
- Seeks to reflect care provided under Federal, State, and private payers (e.g., combining as possible Medicare, Medicaid, employment-based and individual coverage) and, as possible, the Veterans Administration, Department of Defense.
Question 4. Engaging providers to improve
Responses that reflect the use of standard performance information and greater coordination among quality improvement efforts should be rated more highly.
At a minimum, the response should describe the process by which providers are engaged in ongoing dialogue about improving information accuracy and interpretability.
Question 5. Facilitating consumer decisionmaking
The applicant is asked to describe the collaborative approach to facilitating consumer use of standard performance information. At a minimum, the response should include how the collaborative will address public reporting. Approaches can vary. For example, the use of public Web sites, employer guides to health plan enrollment, etc.
The following principles/aspirations can be used as prompts when reviewing responses:
- Performance information created is a "public good" available for any users.
- Where standard performance information is generated by a third-party, there are mechanisms to ensure that the basis of any reporting is transparent and subject to review.
- Supports for linking consumers' cost of care with quality of care performance information.
- Promotes access to performance information at "teachable moments" for consumers.
- Shares performance information with those who will use and distribute the information to consumers (e.g., health plans, state/local public agencies, private vendors).
- Seeks to identify how relevant and actionable cost information—such as actual cost exposure of a patient for a total episode of care—can be provided by entities, such as health plans, that have benefit and network design information.
- Assesses use of reports by consumers.
- Agrees to follow AQA Principles for Public Reports on Health Care.
- Makes the release of performance information to third-parties conditioned upon agreement to comply with AQA Principles for Public Reports on Health Care.
Question 6. Promoting policies and incentives for better performance
The following principles/aspirations can be used as prompts when reviewing responses:
- Promotes use of consistent performance information and incentives/payment used in pay-for-performance programs across private health plans and purchasers and public purchasers.
- Facilitates those being measured fully understand and provide input into incentive/payment programs.
- Shares performance information with payers and purchasers (public and private) to support rewards programs and promote the use of standard performance information.
- Makes the release of performance information conditioned upon agreement to comply with AQA Principles for Public Reports on Health Care.
Question 7. Promoting health information technology and health information exchange
Responses should specify whether the collaborative is directly, or through alignment with regional health information networks, facilitating the use of interoperable health information technologies and health information exchange. More specific plans and processes should be rated more highly.
The following principles/aspirations can be used as prompts when reviewing responses:
- Promotes migration to routinely capture data elements for performance measures as part and parcel of care delivery process through electronic means (electronic health records, etc.).
- Promotes technology (e.g., health information exchange, electronic health records, personal health records, etc.) that is structured to support data elements for performance measures
- Leverages electronic information as available
- Agrees to use and comply with relevant Healthcare Information Technology Standards Panel (HITSP) standards as applicable
Question 8. Capacity: staff/consultant arrangements to provide needed expertise, ability to raise funds or in-kind support from multiple stakeholders, and ability to manage projects and finances
Reflect on the magnitude of activities described in responses to the preceding questions. Determine if the staffing arrangements, funding or in kind support, and historical project management seem feasible given the activities proposed. Responses that are more specific and seem realistic should be rated more highly.
Question 9. Supporting transparent processes and conducting ongoing improvement efforts
Review how the collaborative demonstrates or plans to share lessons learned with the community and others. Assess how the collaborative will review its effectiveness in accomplishing stated goals.
Current as of April 2008
Internet Citation:
Detailed Guide to Chartered Value Exchange Scoring. April 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/value/cvescoringgd.htm
540 Gaither Road Rockville, MD 20850