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 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.
Proposed Rule Amendment
Minnesota Rules, chapter 4654, Proposed Expedited Amendments to Rules Governing Health Care Quality Measures, was published in the January 13, 2020 edition of the State Register This publication only includes the proposed changes to the rule. The current rule in its entirety is available at Quality Measures: 2019 Report Year.
The publication of the proposed amendments to the rules initiated a formal 30-day public comment period that closed on February 12, 2020. The Final Rule and measure information will be published on Quality Measures: 2020 Report Year this spring.
MDH summarized key proposed changes for quality measurement and reporting in 2020 in the memo posted below.
The proposed rule amendments and the appendices are available for download below.
- Minnesota Statewide Quality Reporting and Measurement System, Proposed Rule Amendments (PDF)
- Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654, December 2019 (PDF)
Physician clinic measure specifications referenced in Appendix A
- Optimal Diabetes Care Composite (PDF)
- Optimal Vascular Care Composite (PDF)
- Optimal Asthma Control Composite (PDF) and Asthma Education & Self-Management (PDF)
- Colorectal Cancer Screening (PDF)
- Depression Remission at Six Months (PDF)
- Pediatric Preventive Care: Adolescent Mental Health and/or Depression Screening (PDF)
- Health Information Technology Survey for Physician Clinics (PDF)
Hospital measure specifications referenced in Appendix B
- Hospital Readmissions Reduction Program Excess Readmission Score (PDF)
- Emergency Department Stroke Registry Door-to-Imaging Performed Time Indicator (PDF)
- Emergency Department Stroke Registry Time to Intravenous Thrombolytic Therapy Indicator (PDF)
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.