Annual Quality Rule Update
Minnesota Statutes, section 62U.02 requires the Commissioner of Health to establish a standardized set of quality measures for health care providers across the state. To implement the collection of quality measurement data, the Minnesota Department of Health (MDH) has developed the Minnesota Statewide Quality Reporting and Measurement System (Quality Reporting System), created through Minnesota Rules, chapter 4654. This Rule compels physician clinics and hospitals to submit data on a set of quality measures to be publicly reported and also establishes a broader standardized set of quality measures for health care providers across the state. MDH collects quality measure data, while health plans may only require providers to submit data on those measures that are part of the standardized set.
The Commissioner of Health is required to evaluate the measures included in the standardized set of quality measures every year. Typically, MDH updates the Quality Reporting System measure set annually through a process that includes seeking public comment and recommendations from the community, and concludes by issuing an updated administrative Rule. The Rule and appendices describe specific data elements that providers are required to submit to MDH for each measure.
MDH is not promulgating the Rule for the 2019 reporting year, because it is not making significant changes to reporting requirements for physician clinics and hospitals. In its place, MDH will issue technical guidance in November about changes measure stewards have made to measure specifications and the removal of nine hospital measures to maintain alignment with Centers for Medicare & Medicaid Services requirements.
In parallel, as directed by the Minnesota Legislature, MDH has been developing a quality measurement framework in collaboration with a broad group of stakeholders. This framework will inform future measure set updates.
Please subscribe to MDH's Statewide Quality Reporting and Measurement System Updates to stay informed of measurement framework development, opportunities to provide input, and future rulemaking activities.
Standardized Measure Recommendations Criteria
The standardized set of quality measures includes the measures for which the Department directly collects data, as well as a broader set for which health plans may require providers to submit data. The Commissioner of Health established these measures in Minnesota Rules, chapter 4654, and is required to review them on an annual basis.
Recommendations must address how addition, removal, or modification of a quality measure relates to one or more of the following criteria:
- the magnitude of the individual and societal burden imposed by the clinical condition being measured by the quality measure, including disability, mortality and economic costs;
- the extent of the gap between current practices and evidence-based practices for the clinical condition being measured by the quality measure, and the likelihood that the gap can be closed and conditions improved through changes in clinical processes;
- the relevance of the quality measure to a broad range of individuals with regard to (1) age, gender, socioeconomic status, and race/ethnicity (2) the ability to generalize quality improvement strategies across the spectrum of health care conditions, and (3) the capacity for change across a range of health care settings and providers;
- the extent to which the quality measure has either been developed or accepted, or approved through a national consensus effort;
- the extent to which the results of the quality measure are likely to demonstrate a wide degree of variation across providers; and
- the extent to which the quality measure is valid and reliable.