Aligning Local and National Initiatives to Improve Cancer Care

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More than 1.5 million cases of cancer are diagnosed in the United States each year, and cancer is the second leading cause of death, according to the Centers for Disease Control and Prevention. While the impact of the disease is widespread, advancing age remains the most important risk factor.

Fortunately, federal, state and local initiatives are working to reduce the impact of cancer on older Americans. The Centers for Medicare & Medicaid Services’ Quality Payment Program uses the Merit-based Incentive Payment System (MIPS) to align quality measures to deliver better cancer care to patients nationwide.

At the same time, state initiatives such as the Minnesota Cancer Alliance’s Cancer Plan Minnesota 2025 have goals and quality measures that seek to reduce the burden of cancer. Cancer is the leading cause of death in that state and accounts for nearly 30,000 diagnoses each year.

While these programs aim to achieve similar goals, their structures do not always provide a clear path for how individual clinicians can efficiently participate in initiatives simultaneously. Health care organizations and clinicians face undue burden if state and federal initiatives do not align. When a new initiative is announced, clinicians may be less likely to participate if they don’t have the time to assess how it fits in with their current strategic direction.

“With more than 740 reporting measures for clinics and hospitals across federal and Minnesota reporting programs, clinicians can feel overwhelmed with how to approach reporting and prioritize their quality improvement efforts,” said Candy Hanson, program manager at Lake Superior Quality Innovation Network—the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) serving Michigan, Minnesota and Wisconsin. “Reporting can feel like a distraction from their work with patients and providing quality care.”

To help local clinicians more easily participate in both federal and state programs, Lake Superior QIN created a tool to cross-compare the goals of the Quality Payment Program and Cancer Plan Minnesota 2025.

Results

The cross-comparison found that the programs were strongly associated, with 46 cancer-related MIPS quality measures falling under the Cancer Plan Minnesota 2025’s goals of prevention, detection, treatment, survivorship and quality of life. The Minnesota Cancer Alliance has used the crosswalk in discussions to facilitate implementation of the cancer plan. Lake Superior QIN has used the crosswalk information to illustrate how cancer measures may be appropriate choices for MIPS and to aid discovery of workflow issues that may impede data capture for the Quality Payment Program.

The programs’ related quality measures and the cancer plan were presented at a Stratis Health Community Outreach Committee meeting, which included Minnesota’s Medicare Health Care Advisory Council. At the meeting, QIN-QIO staff solicited consumer input about value in cancer care.

Additionally, Lake Superior QIN is providing guidance to organizations about the need to verify that their preferred reporting methods will support their chosen MIPS measures. Working with clinics, Lake Superior QIN has supported organizations that have found their electronic health record systems are not configured to capture appropriate data for their preferred measures.

Moving forward, Lake Superior QIN plans to continue coordination with clinics to help them optimize systems to appropriately track data and effectively participate in applicable quality improvement initiatives.