Serious Illness Quality Alignment Hub
The Center to Advance Palliative Care is coordinating a national effort to align the existing U.S. health system's quality assurance mechanisms with the best practices in caring for patients facing serious illness.
What is the Serious Illness Quality Alignment Hub?
The U.S. health care system presents a number of opportunities to hold providers accountable to evidence-based standards and quality care delivery, including:
Private employers (“purchasers”), which make decisions about the benefits to be included (or not included) in the health plans, provider networks, and services offered to their employees
Private health plans, which can offer incentives (i.e., financial bonuses and penalties) and establish requirements for their network providers (e.g., accreditation and/or certification programs)
The Centers for Medicare & Medicaid Services, which can impose specific requirements and incentives through Medicare’s conditions of participation, regulation, value-based purchasing programs, and public reporting
States, which oversee health plans, licensure, and Medicaid, and can spearhead targeted quality assurance initiatives
With support from the Gordon and Betty Moore Foundation, the Serious Illness Quality Alignment Hub brings together palliative care experts and U.S. health care quality leaders, both to determine a parsimonious set of quality measures and standards and then expedite their adoption by the accountability systems listed above.
Why do we need this Hub?
Currently, millions of Americans are living with one or more serious illness, such as cancer, heart, lung, kidney, and neurological disease, and their ranks are expected to swell with the aging of our population. The care delivered to these patients varies dramatically across the country. At the same time, there already exist a variety of mechanisms to drive provider behavior. Building from this foundation, which to date has focused on prevention and cost efficiency, the Hub will work to adapt those mechanisms to reflect the measures and practices that matter most to seriously ill patients and their family members.
"While systems of accountability already exist, they do not yet adequately reflect what's needed by the sub-population struggling with the burdens and stresses of serious illness. We need to ensure there is sufficient attention to well-being after an illness has occurred."
Allison Silvers, MBA and Amy Kelley, MD, co-directors of the Hub
Who participates in the Hub?
The Hub convenes more than 50 organizations to provide insight and feedback on strategies to improve the quality of care delivered to people with serious illness. Organizations participate in one of two committees.
The quality measurement effort, led by the National Quality Forum, convenes a committee comprised of project leaders working on quality measures, clinical guidelines, population definition, and data collection. This effort involves gathering input from a broader range of stakeholders and creating a “playbook” to prepare providers for measurement and reporting expectations.
A second accountability committee convenes accreditation bodies, CMS quality staff, ACOs, health plans, purchaser organizations, and others to review public and private opportunities for adoption and also to advance the most actionable and high-impact opportunities.
What resources are available through the Hub?
Because the Hub is an ongoing effort and will continue to prepare and disseminate resources to advance high-quality serious illness care, check our website often for new information. Foundational resources include the following:
- Clinical Guidelines for Quality Palliative Care, National Consensus Project, National Coalition for Hospice and Palliative Care
- National Voluntary Consensus Standards: Palliative Care and End-of-Life Care–A Consensus Report, National Quality Forum
- Banff Convening Summary Report, a synthesis report from the Gordon and Betty Moore Foundation convening in May 2017 on the issue of accountability for serious illness care in community settings
- A special issue of the Journal of Palliative Medicine focused on quality measurement and accountability for community-based serious illness care
Clinical Guidelines and Standards:
- Building Momentum: The Science of End-of-Life and Palliative Care, National Institute of Nursing Research
- Cancer Program Standards 2012: Ensuring Patient-Centered Care, Commission on Cancer
- Supplemental 2016 Edition, Cancer Program Standards: Ensuring Patient-Centered Care
- Palliative Care and Cardiovascular Disease and Stroke, American Heart Association, American Stroke Association
- Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update, Journal of Clinical Oncology
- NCCN Guidelines for Supportive Care - Palliative Care, National Comprehensive Cancer Network
- Medicare Alternative Payment Model Proposals for Serious Illness
- Medicare Care Choices Model, Center for Medicare and Medicaid Innovation (CMMI), Center for Medicare and Medicaid Services (CMS)
- Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: A Workshop, November 29, 2017, National Academies of Science, Engineering and Medicine
- Certification for Palliative Care Programs, The Joint Commission
- Advanced Certification for Palliative Care, DNV GL Healthcare
- Distinction in Palliative Care, Accreditation Commission for Health Care (ACHC)
- Accreditation, Commision on Cancer
Data Collection and Benchmarking:
- Mapping Community Palliative Care, Center to Advance Palliative Care
- National Palliative Care Registry, Center to Advance Palliative Care
- Global Palliative Care Quality Alliance, Duke Palliative Care
- Palliative Care Quality Network, UCSF
- The Roundtable on Quality Care for People with Serious Illness, National Academies of Science, Engineering and Medicine
Provider Transformation Support:
- Center to Advance Palliative Care organizational membership
- Serious Illness Care Project, Ariadne Labs, Harvard University
- VitalTalk communication skills training resources
For any questions about the Serious Illness Quality Alignment Hub, email firstname.lastname@example.org.