On Page 27 of the CMS Quality Strategy Document “Engage Individuals and Communities to become partners in their care” is stated to be an overall objective of this quality initiative. The author(s) of this article then provide four specific outcomes which demonstrate this. How might the HIM Profession contribute to the attainment of each of these four specific outcomes?
Authentically engaging individuals, families, caregivers, and communities as active partners intheir care ensures that the health care systems that serve them are respectful of and responsiveto their preferences, needs, and values. This partnership is essential to person-centered careand to improve health care quality, safety, and equity. The Engagement goal of the CMS NationalQuality Strategy focuses on two components of engagement. The first is ensuring thatindividuals and caregivers have information to make the best choices for their health. Thesecond is ensuring the voices of individuals are valued and that they directly contribute to howCMS evaluates the impact of its programs on quality, safety, and equity.Key strategies for promoting the delivery of person-centered care include collecting experiencemeasures and person-reported outcomes (PRO) and PRO-based performance measures (PRO-PM). Experience of care measures can assess a wide range of interactions that individuals havewith the health care system and the aspects of those interactions that they value, such as timelyappointments, easy access to information, and good communication with health care providers.A PRO is any report of an individual’s health condition or health behavior that comes directlyfrom the individual (or proxy when appropriate), without interpretation of the individual’sresponse by a clinician. A PRO-PM captures person-reported outcome data on meaningfuloutcome metrics and incentivizes collaboration and shared responsibility for improving patients’health along the full spectrum of care. Self-reported data are a rich source for measuringoutcomes such as health-related quality of life, symptoms and symptom burden, and healthbehaviors.Together, experience surveys, PROs, and PRO-PMs provide the individual’s perspective of theirown health, their experience of the treatment or service, and the outcomes that are mostimportant to them. Providers can use this data to assess the person-centeredness of the carethey deliver and inform their treatment plans, and CMS can use PRO and PRO-PM data toincentivize providers to deliver high-quality care.Key Actions to Ensure Engagement to Improve Health Care Quality• Incorporate individual and community input into strategy and policy.• Expand use of person-reported outcomes and experience measures.• Give individuals access to their own health data and meaningful information.• Provide a platform for public reporting.Engagement Goal Connections• How Safety Affects Engagement: Integratingengagement and safety throughstandards and best practices and ensuringthat care is understandable are importantaspects to improve care safety. Forexample, the National CLAS Standards canshape both safety and engagementpractices. These standards can helpensure that individuals, families, andcaregivers understand the relevantinformation about their care and servicesin a way that is linguistically accessibleand culturally appropriate, and that canhelp to build the safety culture needed inthe health system.• How Interoperability Affects Engagement:Interoperability helps to promote thetransfer of data across systems.Advancements in interoperability can giveindividuals and their families andcaregivers access to meaningful careinformation in a timely manner to informdecisions about their care. Thisinformation can increase the engagementof those receiving care for shared decisionmaking and improved health outcomes.• How Outcomes Affect Engagement: Publiclyreported data on care delivery, such asprovider performance data shared inaccessible formats and at appropriateliteracy levels, can help engage individualsand promote more informed care choices.Promoting the availability of relevant datais an important aspect of the Outcomesgoal of the CMS NQS and can continue toshape how individuals evaluate their carechoices.Incorporate individual andcommunity input into strategyand policy.To overcome biases in the health caresystem leading to health disparities, CMSis committed to hearing the voices of allthose the Agency serves and reflectingtheir needs and preferences in programpolicies and participation requirements.CMS hosts listening sessions for thosereceiving care and their caregivers thatcover policies and program changes, andCMS works with partners, such as patientand other advocacy groups and technicalassistance providers, to ensure peoplefrom diverse backgrounds are includedin health care decision making.For example, nursing homes can activelyengage residents, families, andcaregivers in quality activities, such asidentifying, addressing, and improvingsafety concerns. These Resident andFamily Advisory Councils provide aforum for nursing home staff to meetwith and receive suggestions fromresidents and their families andcaregivers.Federal rules require Medicaid managedcare plans that cover Medicaid long-termservices and supports (LTSS), Programsof All-Inclusive Care for the Elderly(PACE), and dual eligible special needsplans (D-SNP) to maintain enrollee orparticipant advisory committees that areconsulted on various issues, includingways to improve health equity.While developing the framework for theMedicaid & CHIP Quality Rating System,CMS used multiple venues to getfeedback from interested parties. This
