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Quality Measure Development: A Practical Guide for Patients, Providers, and Advocates

Quality Measure Development: A Practical Guide for Patients, Providers, and Advocates

So hello and welcome everyone. We are kicking off a new year of MMS Information Sessions under the Measures Management System (MMS) contract. I am Brenna Rabel, and I oversee Education & Outreach on this project. Today’s session is on the topic of getting patients and providers involved in measure development. In the past, we’ve talked a lot about the opportunities throughout the measure development process for stakeholder involvement, but today we’re doing a deep dive
into some practical guidance that you can use or share with folks in your networks. So I’m going to begin with a detailed explanation for how to self-nominate for a technical expert panel (TEP). And then I’m going to turn the presentation over to Dr. Nicole Brennan who is the senior project director of the Measures Management System (MMS) contract at Battelle, to lead a discussion about submitting public comments, both via the MMS public comment page and
through the Federal Register. And then for both topics, we’ll provide links to resources that you may find helpful in this work. So as most of you probably know by now, these Info Sessions are part of an ongoing effort to engage measure developers and other
stakeholders in quality measurement topics. That’s an effort that also includes a series of
newsletters and bulletins, along with special announcement emails, public webinars and routine updates to the Measures Management System (MMS) website. A change this year is that we’re going to be holding these meetings or these Info Sessions bimonthly rather than monthly, but they’re still going to focus on a wide range of topics related to quality measure development. So before we jump into the presentation, I do want to cover a few housekeeping items. First, today’s session is being recorded. Second, all participants will be muted during the call. We are going to have an opportunity
for Q&A at the end of the discussion during
which the lines will be unmuted for questions. You probably noted at the beginning of the session that we’re going to use a hand-raise feature for questions, but you can also always feel free to submit a question via the chat function, or via the Q&A feature if you prefer to type your question rather than to speak up. We are also going to be opening up a poll during today’s conversation, during today’s discussion. It will be on the right side of your screen. Please do take a few minutes during the call today to answer those questions. It will really help us out as we plan content for future webinars, which since we’re only doing six this year, we really want to make sure that
they pack a punch, so we’ll go over the results of that poll in our next Info Session, if you’re
curious. And then finally, the presentation slides from today’s session have been posted to the MMS website for your reference, and the recording of today’s presentation will be posted to the CMS YouTube page at a later date. Okay, so here’s the agenda for today’s Info Session. We’re going to begin with some general background about the ways that stakeholders can get involved in measure
development. And then we’ll provide that step-by-step guidance for nominating and participating in a TEP and submitting public comments. And then at the end of the call, as I said, we will open up the discussion for questions. So for those of you who attended the public webinars in June and July, you may recognize some of the information on this slide. So this slide’s actually leading quality measure development. There are kind of three main ways that measure developers typically engage patients, clinicians, and other stakeholders in the
measure development process. That’s via TEPs or workgroups, by soliciting public comment and through measure testing. So TEPs, technical expert panels or even like Patient and Family Advisory Councils (PFAC) are convened by measure developers to support measure development, and the level of effort for each of these varies from project to project, but they’re always involved in some capacity sort of reviewing the measure specifications and thinking through how those should take shape and be implemented. “Public comment” is really just an opportunity for the public to provide feedback on measures under development (MUD) or on measures that are used in CMS programs, and again we’re going to talk about both of those things later during this call. And then another area, as I said, is “testing.” It’s not a topic we’re going to get into a lot of detail with today, but it’s worth mentioning that
measure developers often recruit patients or clinicians to participate in measure testing, and those sorts of opportunities are often advertised both via the MMS newsletter and through the announcements that we circulate in our listservs. So if you’re interested in learning about those opportunities and you don’t think you’re already getting those announcements, please
do reach out to us at: [email protected] to make sure that
you’re on those listservs. Okay, so let’s jump in with technical expert panels (TEPs). So starting really basically, where would one go if they wanted to participate in a TEP? So all CMS measure developers post their calls for TEP nominations on the MMS website, so that’s the best place to start. As I mentioned earlier, these slides are up on the MMS resources page. So you can certainly use or share the link that’s included here, but to navigate there you can also go to the MMS website. I find it by just Googling “CMS MMS” and then click on the “get involved” tab. That will open up a drop-down menu, and from there you can select “technical expert panels.” That will take you to the list of all the
current TEP opportunities on CMS measures projects. So, as I said, these opportunities are also advertised in the MMS newsletter. So if you’re not already signed up for that, again I would encourage you to do so, so you can see when new opportunities are posted. So now once you click on “technical expert panels,” you’ll find yourself on a page that more than likely includes multiple postings. Each posting will look something like this, as you can see here, so you’ll find lots of information about each TEP opportunity, so dates for the nomination period, in addition to a broader project overview that will tell you a little bit about what kind of work the TEP is
supposed to support. You will also find information about the TEP requirements, including information about time commitments, whether meetings will be in- person or via web conference, and an estimate of the number of meetings that you might be expected to attend. So these postings will also include information about how to nominate yourself or someone else and provide contact information for someone who can field questions about the TEP, should you have any. It’s also super important to note that there is a “downloads” section at the bottom of the webpage. You won’t be able to see it unless you scroll all the way down. So clicking on the relevant “downloads” for each opportunity will allow you to view the TEP charter and the TEP nomination form along with any other information that the measure developer felt was important to share with potential nominees. It’s very important to know that that’s there and to look for it. So anyone interested in nominating themselves or others to participate in a TEP should be aware of those sort of general
requirements for doing so. So all TEP opportunities will include a nomination form in that “downloads” section of the TEP page. So this form should be completed and signed by nominees, and then submitted to the developer via the contact email included in the
posting. All TEP nominees will also be required to disclose any potential conflicts of interest. So it’s worth noting that conflicts of interest don’t necessarily preclude a person from participating in the TEP, but it is crucial that this
information is disclosed at the outset of the process. So conflicts of interest include any activity past or present that may have competing or incompatible concerns or aims with the works
being done under the project. So, for example, a conflict of interest may arise if an individual is participating in another TEP, or on another measure development project on
a related topic, and so activities such as that would need to be disclosed in that form. Nominees are also expected to complete a “statement of interest” summarizing relevant experience or expertise. This really shouldn’t take up more than two pages. It’s simply an opportunity for nominees to explain their background and to highlight why their perspectives would be valuable on
the TEP. For patients or patient advocates this might be sharing personal experiences relating
to the work that’s being done by this measure development contractor and explaining any other experience working on expert panels or patient panels that would highlight how you
can contribute to this TEP. For physicians and other technical experts, this is an opportunity to highlight previous TEP or NQF experience, quality improvement expertise, or clinical specialty areas that make you a good fit for this particular opportunity. Nominees are also asked to submit a résumé or a CV, so keep in mind that the “statement of interest” need not repeat information that’s
already in your résumé. It really should be more related to the work that you do that would specifically apply to the needs of a given TEP. Patients are usually exempt from the résumé/CV requirement; although, you are more than welcome to include one. So there are tons of resources that are available related to TEPs. So under the MMS contract we’ve developed a resource for patients, families and caregivers on ways that they can make an impact on
TEPs. So this would be a fantastic resource to share with individuals who may want to be more involved in CMS or healthcare policy work, but who don’t know exactly how to apply their background to measure development. So this is a user-friendly document, and it provides an introduction to TEPs and quality measures. It explains how TEPs work and highlights how someone can participate in and join a TEP. It also includes information on where to go for additional resources, and there’s a link here included in the slides, or again you can navigate to this document using the CMS MMS website. You also have access to our companion piece that is targeted more to measure developers who want to know more about how to effectively recruit and establish a TEP, and how to better engage TEP members in discussions. So the information in this document is complementary to what’s already included in the CMS Blueprint about TEPs, but it includes more in-the-weeds practical guidance on things
like meeting logistics, for example. So for those of you working on measure development projects, this is a resource that might be worth sharing with internal staff who might support or lead technical expert panel (TEP) recruitment, or technical expert panel management. Again, that link is available here in this slide which is already on the MMS webpage. CMS is also overseeing the development of the person and family engagement (PFE) toolkit. So this is a highly detailed document that covers best practices for engaging patients and families in measure development. TEPs are a large part of this; although, this document covers a wider range of topics beyond that. So it includes information about recruiting patients and family members, facilitating engagement of those folks, strategic planning for your project and other resources for measure developers that want to more effectively bring in patient perspectives during
measure development. So in addition to the documents I just described, there are a number of other resources that may be worth sharing with folks
in your networks with interest in these areas. So for a quick one-pager on what TEPs are
and how they’re used, you can share the TEP factsheet from the MMS website. There are also a number of MMS newsletter articles that are archived on the MMS website that may be of interest to those who’d like to know more. And then finally, we conducted an Info Session last summer on the topic of TEPs. That was led by Jennifer Brustrom who led the
MACRA TEP under this contract, and then also Kyle Campbell from HSAG who has lots of experience leading TEPs for measure development projects. You can access slides from that presentation, again by clicking on the link in these slides. So before we move into the section on “public comment,” I did want to take a moment to talk about social media. We’ve received lots of requests for information about using social media to recruit for TEPs and to advertise other related opportunities. This is still a relatively new approach in the quality measurement world, so we don’t have a ton of data to share with you about it. What we do know is this: On the plus side, social media advertising through channels such as Twitter or LinkedIn are extremely low cost to implement. Depending on your organization’s reach on social media, this approach has the potential to be fairly high impact. That said, it does take some work to cultivate a social media following, and it’s hard to know exactly who you’re reaching through those
channels. So speaking from a little experience, we did some social media outreach to recruit for the public webinars that we did over the summer. We polled registrants to determine how they found out about those sessions. About 1% of the folks who responded to the poll said they heard about the opportunity through Twitter. However, that doesn’t account for some intangibles like the number of organizations that saw the opportunity on social media and then shared the announcement through their networks. So in some social media outreach, to recruit folks for your TEPs could be a solid way to expand your reach in terms of making TEP opportunities known to your networks, but unless you’ve taken this approach in the past with good results, I think we would suggest using this as a supplement to more tried and true recruitment approaches. All right, and with that we are going to jump over to “public comment.” So Nicole, I’m going to hand you the ball. Great. Thank you, Brenna. So we do talk a lot about public comments when it comes to measure development. We believe that this really is an essential part of the measure development process, and it ensures that CMS quality measures are developed transparently. It’s an opportunity to, you know, collect a balanced input from stakeholders on measures that are currently being developed or proposed through a rule. It provides a lot of critical feedback as well as good suggestions on how measures might be better tuned in to the realities of practicing
medicine. Whenever we tell stakeholders that they can always get involved and always submit comments, you know, we don’t really stop to
think past that. So with the whole theme of today’s presentation, it really is sort of what’s the practicality of doing that? What does this even mean when we say “submit a public comment?” So to start, it’s important to note that there are sort of two different channels for submitting comments. The first channel is related to measures that are currently being developed, or programs that are not part of the rulemaking process. So, in other words, you might see measures that are still actively undergoing testing that aren’t yet final, or in use in a CMS program. CMS measure developers are actually required as part of their measure development process to seek public comment as they’re developing their measure at various points in the development process so that they can gather feedback and be iterative in their measure development process trying to make sure they’re getting that full stakeholder input before a measure ever goes into the rulemaking
system. These public comment opportunities are nearly always posted on the MMS website. So very similar to, as Brenna was saying, for the TEP opportunities we try to advertise these through our listserv and our announcements so that everyone has a chance to know that they’re put up there. Measure developers will also often post specific questions or topics which they’re asking for feedback on, so you can help guide your response to what they are specifically looking for in that time period of their comments, and the concerns that they’re trying
to get your input on. So as I noted, this is the same system that’s used for programs that are not currently also using the rulemaking process. So, for example, recently CMS wanted feedback on the Hospital Star Rating System. As that system is not part of rulemaking, the
public comments went through the CMS website, Measures Management System
(MMS) website. So a more formal public comment process, if you will, comes through the CMS rulemaking. So, in this case, stakeholders are invited to share comments about any of the measures that are being put out in a proposed rule. So rules start first as being proposed. They come out and CMS says, “Here are all the things that we are thinking about doing. Here are the measures we’re thinking about adding to the program. Here are some that we think we might retire. Here are the time periods that we’re considering implementing them.” And then it goes out to stakeholders to provide comments on, and they will pull all of those back together and respond to them and put
that out in a final rule. I have seen numerous times where, you know, a measure is proposed and the comments come in. CMS analyzes those comments and talks about them more with the technical expert panels (TEPs). And then they decide, you know, these comments made a lot of valid points. We either need to go back and make some adjustments to this measure, or we’re not going to move forward with it, or thank you for your comments validating that this is something that’s really needed. We’re going to finalize this measure, and it will begin, you know, in the next calendar year (CY) or fiscal year (FY) or whenever the
program begins their next set of measures. So if you’re looking to put in a public comment through the MMS webpage, I’m a big fan of search engines. The best way really to get here is, you know, just go to your favorite search engine and put in “CMS MMS,” or “Measures Management System.” It should take you right to our webpage. Just like looking for technical expert panels (TEPs) on the webpage, you’re going to go here to “get involved.” When you pull that down, you’ll also see information about our MMS Listserv as well as the option to click on “public
comments.” If you look at the bottom of that screen there, you will see that you can look for “currently accepting comments,” as well as comments that are—that have already been closed but maybe have some updates to them. So if you were to click on that first one which is the “currently accepting comments,” if you went even today and looked at this, what you would see pull up is the pathology electronic clinical quality measurement measures (eCQMs). So there is the American Society of Clinical Pathology (ASCP) is working with CMS under a cooperative agreement to develop a clinical
quality measure (CQM). They have gotten to the point where they’re interested in seeing what you think about the work that they’ve done so far. If you are going to provide a comment on behalf of your organization, it’s important to include your organization’s name, your
contact information. If you’re commenting as an individual, simply identifying or providing any contact information is also very helpful. Please, you know, be specific on what you are commenting on. And then you can submit general comments on the entire set of measures or whatever is being asked for on that page. Just to go back up here briefly to look at the “updates to close” comments, if you were to click on that today, you would actually see some updates as I noted before. CMS had previously asked for comments on the Hospital Star Rating System. Those comments were collected and responded to. If you clicked on “updates to closed comments,” you could scroll down to the bottom where we have put in those
documents. You’d be able to pull up all the comments as well as executive summaries, and reports out on CMS’ analysis of the comments and sort of
next steps with that system. So again, if you were to head over to your favorite search engine and put in “CMS Federal Register,” it should take you straight to
CMS’ part of the Federal Register website. You can set up subscriptions there and receive email notifications when proposed rules are
coming out, so that you’ll know if there’s something that you’re interested in commenting on there. If you are interested in just going there, you know, again today and looking for a specific program or topic, you can use the keyword
search. It will pull up all the rules or proposed rules that are related to that topic. This is what it’s going to look like when you find the proposed rule that you are interested in commenting on. You’ll click into the rule. If it is still open for comments, then you’ll have a box at the top that says “submit a formal comment.” It will take you to the spot where you can fill out the form to complete that. Just briefly, if you look over to the side of the rule, there’s also some additional tools there that will help you navigate the rule, print it, or
turn it into a PDF so that you can share it. If you keep it in the web browser and do a search and find for specific words or terms,
that will help you get through the rule and go to the sections that you’re most interested in as well. So a lot of different ways to review a rule, and then go back to provide your comments on them. So here’s what it is going to look like when you click that “submit your formal comment.” You really want to clearly identify the issues within the rule that you are commenting on. So if you were commenting on a particular word or phrase, sentence, it is very helpful to CMS for you to note the page number or the column or the paragraph that you are referring to. So if your comment is very specific to a very specific part of the rule, then you have to
let them know where that is so that they can go directly there, review what you were looking at, and then put that into the context of your comment. A couple of other tips for you when putting in public comments. First and foremost, you know, it’s there in the name. These comments are public, so please do not include any personal health information in your comments. We want to protect your personal health information, so not putting them in there is helpful to us in protecting your privacy as
well. And then, you know, well-supported comments can have a strong impact on a measure. If you are providing comments and, you know, really citing any scientific evidence that backs up your comments, that is very helpful. If you are putting the reasoning behind your comment, that can be also very useful— providing facts, data, expert opinions. Try and be concise within your comment. We do want to know exactly what you’re thinking or what stakeholders are thinking, but trying to get it into a concise statement, paragraph or a couple of paragraphs is most helpful. Letting us know, you know, who you are and what your expertise is, what your experience is and if you’re a patient. That’s also incredibly impactful. We want to know and we want to hear your story. Acknowledging differing perspectives that you may have from how the measure has been presented is very important. If you can provide alternatives, that also is helpful. So you may not agree with how or the time period in which a measure is going to be released. So if you have an alternative to that saying, “I
believe it would be better if you delayed this for another year or six months,” or if you have alternatives to wording. If you disagree with how something is being worded, it’s helpful to hear that from you as well. Overall, just being as constructive in your
comments as possible is really probably one of the most helpful tips that we can provide. On our website we do provide these tips as well as some additional information on the public comment process. If you are part of a specialty society or a patient advocacy group, and you want your stakeholders to know more information about this, you can quickly pull down this resource to share with them. That should provide them with, you know, the same general information that we’ve gone over today. Part of the wrap-up here around public comments is just to provide you with these links to monthly announcements to the Federal Register so that you can subscribe to updates to that, as well as the link to the MMS website. All of these presentations do also get posted
onto the MMS website for you to refer back to later. Since we are all about making sure that this webinar is about, you know, helping you and being very practical in these types of recommendations or suggestions for stakeholder engagement, we wanted to offer plenty of time for you to ask any questions or
provide any comments back to us. So I will hand it back over to Brenna. Thanks, Nicole. Well, before we jump into the discussion questions, I just want to remind folks who maybe joined a little bit late that there is a poll open in the WebEx right now that we would love your responses to. So if you could just take a moment before you sign off today to complete those questions, that would be very helpful to us. So at this time, the phone lines will be unmuted for questions. Please remember to mute yourself, if you’re not talking to help us keep background noise to a minimum. If we get too much background noise when we unmute the lines, we will have to remute folks and then just limit questions to the WebEx chat
and Q&A features. Thank you. Okay, folks, sorry. You can feel free to submit your questions via Q&A and chat. We already have a couple that I’ll get us started with, but yeah, please feel free to, you know, continue kind of mulling over
your questions and then adding them via that feature. So the first one, Nicole, is probably for
you. “How long are the calls for public comment on the MMS webpage usually open?” It can really vary based off of, you know, the program. It depends on—many are open for 14 days. Sometimes they’ll be extended to a month. Brenna, have you seen longer periods than
those? Yeah, I’ve usually seen them about 30 days. Although, you’re right, some are 14. Usually if comments are pretty thin, then developers will extend the public comment period to make sure that they get a good
representation of comments, but I wouldn’t count on it. I think if you see a public comment period open for 30 days, I would try to get those comments in before that deadline to make sure that your
thoughts are heard. Yeah, and that period of timeframe is similar for the call for technical expert panel (TEP) announcements as well. Great. Thanks, Nicole. Another question. “Is there a way to follow up with CMS or developers about their responses to my comments?” Yeah, so in the proposed rule you will, if you’re submitting through the rulemaking process, you will see sort of the questions listed out. Sometimes they’ll group them by theme or topics, but then CMS does actively respond to those comments. It’s the same oftentimes for comments that are released through the MMS webpage. The one example that I was giving earlier. If you were to go to the documents that you could download, you could see your question
and CMS’ response to that. That’s lastly at times a good way to see follow-up on your question. Kim, other things to add to that? Sorry, I think that was a great start. I think that you really captured it, you know. Depending on the, you know, number of comments and the method, et cetera, sometimes, you know, we do respond to verbatim comments. Other times, you know, we probably read every comment. Holistically, if we received, you know, 23,000 comments which does happen, you know, like on the QPP or something, you know, a very hot
topic like that. You know, then we will group those comments into themes and respond in that way, you know. I think it also varies in the vehicle as well, you
know. Public comment through a rule and through an NPRM through the Federal Register is a much different process in the kind of more informal, or the public comments that we seek outside of rulemaking, so it’s kind of two different vehicles but they’re both forms of public comment. Thanks. Thanks, both. We have a follow-up question from the first one, but I think it’s probably for you, Kim. “Is there a recommended sort of target number of responses that you’re looking for during a public comment period?” I wouldn’t say that there’s a target number of responses per se, you know? Whenever we put out a public comment, there are perhaps stakeholder groups that we’re kind of looking for that we anticipate may reach out to us through public comment, but there is no set number per se. I think we’re really just hoping, you know, for a broad range of perspectives, you know, from patient-level comments to frontline clinicians commenting to specialty societies, national associations to health plans, you know, et cetera, et cetera, you know. I think that we’re looking for that diversity and that, like I said, variety and perspectives in our public comments, but there’s no specific target
number of responses that we’re looking for. I don’t believe, you know. I can’t speak for each and every program and each and every comment or rule, et cetera, but I think that we typically put, you know, put the comments out for a certain period of time, whether it’s two weeks or 30 days. And then, you know, whatever comments we get in that timeframe is what we work with and what we work to answer and incorporate, et
cetera. Thank you. Yeah, thanks very much, Kim. We’ve got another question that I think I can take answering. “Can you give an example of an individual who should submit a résumé or CV with their TEP nomination?” So yes, most of the time developers are seeking a CV or a résumé from the sort of technical applicant, and so the technical nominees for their TEPs. So that might include clinicians, and by clinicians I’m including not just doctors, but also nurses and other sort of medical caregivers that fall under that bucket. Anybody with sort of clinical knowledge around the topic area. That would also apply to maybe like nursing informatics staff or EHR system representatives so, you know, really anybody whose technical background is the reason that they’re applying to be on the TEP. From the sort of patient perspective, the reason that they’re usually exempt from having to submit a résumé or a CV is just because the assumption is that it’s their lived experiences with the healthcare system. That is the reason that they would be wanting to participate in a given TEP, and usually that’s more effectively spoken to in a statement of
interest. That said, if a patient or family member has some relevant background that they think would, you know, professional background that they think would add to their application and make them a more compelling nominee. For example, if they have a background in
healthcare or advocacy or something like that, then by all means, I’m sure that developers
would be interested in seeing that information in a CV. Okay, we’ve got another question. “What are some avenues or sources to find patients who may be interested in being on a TEP? PatientsLikeMe comes to mind, but are
there other recommendations?” I have some thoughts on that, but Nicole or Kim, do you want to chime in first? Go ahead, Brenna. Sure. So there’s a couple of thoughts. For folks that are, you know, representing measure developers that have already done some testing in the past maybe for other measures or other projects, one great avenue is to work with any hospitals or health systems that you already have an existing relationship with to connect you with like any in-house patient advisory councils that they might have. Usually hospitals or, you know, clinical groups will have kind of a network of patients that are really involved that may be interested in this
type of work. So that would be one avenue worth exploring. I think PatientsLikeMe is also a great example of a way to go about getting patients involved. Reaching out to other sort of national-level or condition-specific patient advocacy groups to share through their networks is another great
option. If you sort of have the time and the funding available, there’s also the option of going through like market research firms to have them help you identify people, you know, healthcare consumers that might be available to help, especially if you’re looking to do something more like a focus group. So those are the ones that come to mind, but I would definitely recommend checking out some of the resources that we shared earlier in the presentation, specifically the patient and family engagement (PFE) toolkit and many resources for patients and families just to get
some ideas on ways to reach out. Yeah, so those resources are probably worth noting were developed, you know, with patients and patient advocacy groups who provided feedback specifically on that, because that is one of the things that we often ask them, you know. What are your recommendations for getting additional TEP members? Some other, you know, thoughts that they’ve had include, you know, as Brenna mentioned, you know, working very closely with your local or national patient advocacy groups. They’re the most linked in and they have great grassroots work that they do, and they have lots of very active patients. Other times also we’ve received suggestions that you don’t necessarily have to have a patient that is currently, you know, suffering from a condition that maybe you are focusing your measure on, but healthy patients or people who are just regular patients every day of the healthcare system have a lot to offer as well. And then some of the resources also talk just about, you know, how to provide incentives for being part of the groups. That can be a major barrier for patients to being part of a technical expert panel (TEP). Unlike the professional attendees who may be
supported by their organization to be part of the technical expert panel (TEP), the patients don’t have that. Some of the considerations that they’ve suggested, you know, including paying for their travel, if that’s what you want to do for the technical expert panel (TEP), but really also talking to the patients specifically about what would be, you know, helpful to them. Sometimes money is not as helpful, because it may preclude them from other services that they are receiving, and so just trying to be as very patient-specific and centered as you can in these efforts is helpful. This is Kim. Just to also add a bit briefly, you know, I definitely agree with everything that Brenna and Nicole, you know, have mentioned. I think oftentimes, you know, there might be a TEP that we’ve done before, or public comments that we’ve received before. So sometimes it’s also about combing through historical data to see, you know, who’s commented in the past. What organizations have reached out to us in the past that may be interested in, you know, supporting a TEP and kind of looping back with them to say, “Hey, you know, you commented here. We would love, you know, we would invite you to nominate yourself, et cetera.” The other reach, you know, it’s kind of more of an internal CMS resource, but something you can definitely invite patients to join as well as, you know, if you’re a CMS contractor. It may be available to you to utilize as well is the CMS person and family engagement (PFE) member network. I am going to try and get that sent out. It’s a little bit difficult to find unfortunately, but I’m going to try and get that sent out in a message so that it, you know, pops up for everyone so that you can file that email and see that resource there. That’s definitely another one, so thank you. Thank you, both. This is not a question, but it’s something worth mentioning that we have a representative from the National Coalition for Cancer Survivorship (NCCS) on this call who has said that they are happy to help connect developers with cancer patients, survivors and family members to
participate in TEPs. So just to note that that is a resource that’s available to you. Kim, this is probably a CMS question. “If a measure developer wants to collect input from patients and caregivers via survey and wants to collect input from more than ten individuals, what does the MACRA exemption process approval look like? How long does that tend to take?” That’s a great question. I know exactly what you’re talking about; however, I don’t generally work on the MACRA team and so I’m not 100% sure of the process that’s involved. It is a thing that if you contact your coordinator, they should be able to follow up with you. I don’t know exactly who asked that question. But if you’re not currently, you know, if you don’t currently have a task order but still need to, you know, would still like to know the answer, we can capture your name and follow up with you in the coming week or so. Thanks, Kim. We will send around an email I guess at the end of this call or, you know, when we’re working on the minutes from this call. We do have some contact information for you, both for the folks at the cancer organization, and then also for CMS’ person and family engagement (PFE) network contractor which is Rainmakers Strategic Solutions. There is a link in the chat function that you can look at to find those folks, but we are also more than happy to send around that contact information to everybody on today’s call to make sure that you have information about some of these more tangible resources for you. some of these more tangible resources for you. All right, any other questions from the folks on the call? Thank you so much everyone so far for your participation. All right, well, I’m seeing no additional questions. I just want to thank you everyone again for your participation today. This was a great discussion. Again, feel free to reach out to us at [email protected] if you have any follow-up questions, or if you want to be connected with any of the folks who kind of raised their hands today to be resources for patient recruitment. Have a great day, everyone.

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