Program Design and Improvement Services

Clinical Quality Measure Development

For more than 50 years, Mathematica has been informing health policy debates and addressing decision makers’ infor­mation needs regarding longstanding issues such as controlling health care costs, designing efficient and effective delivery systems to meet the diverse needs of the population, and measuring and improving health care quality. 

We bring the highest standards of quality, objectivity, and excellence to our work on clinical quality measures for federal, state, and commercial clients. These measures are a critical tool for programs that seek to monitor and improve health care.

We use standardized processes and tools that result in efficient and thorough measure development from measure conceptualization and specification through measure testing, implementation, and maintenance. Our approach hinges on three grounding principles: a solid evidence base for measure concepts, broad stakeholder input throughout the development process, and data-driven decision making informed through quantitative and qualitative testing.

Capabilities


  • Evidence gathering. The best measures are supported by rigorously designed and adequately powered research and evidence-based guidelines. We carefully review literature and guidelines to ensure measures are based on the strongest published evidence.
  • Stakeholder outreach. Clinical quality measures must meet stakeholders’ expectations. Starting with patients, we obtain actionable feedback designed to catalyze adoption of measures across a range of interested parties including measured entities, payers, and medical specialty societies.
  • Specification. We have experience specifying more than 100 claims-based, registry, and electronic clinical quality measures using nationally recognized standards.
  • Testing. Testing is critical to inform our clients’ under­standing of the measures’ feasibility, reliability, and validity. We use a range of techniques and data sources, such as clinical, administrative, and registry data, to vet measures to the highest standards. Testing results are designed to support endorsement decisions by accred­iting bodies such as the National Quality Forum. 
  • Implementation support. We actively support implementation of measures in federal, state, and local quality programs and initiatives by providing imple­mentation guidance for clinicians, hospitals, and states.
  • Maintenance. Measure maintenance is critical to ensure that the measures reflect current guidance and standards. We maintain dozens of electronic clinical quality measures and claims-based measures reported by clinicians, hospitals, and states.

For more information, contact Cindy Cullen, (609) 936-2718, or Sam Simon, (617) 301-8982.

Cindy  Cullen

Cindy Cullen

Senior Director, Business Development

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Samuel Simon

Samuel Simon

Senior Director

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