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With few exceptions, NQF is no longer subject to income tax examinations by the U.S. federal, state or local tax authorities for years ended December 31, 2008 and prior. Management has evaluated NQF 's tax positions and has concluded that NQF has taken no material uncertain tax positions that require adjustment to the financial statements to comply with the provisions of this guidance. 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ORGANIZATION'S MISSION AND PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 1, 4A & 4B & 4C LINE 1: THE NATIONAL QUALITY FORUM (NQF) IS A UNIQUE, MULTI-STAKEHOLDER ORGANIZATION INSTRUMENTAL IN ADVANCING EFFORTS TO IMPROVE HEALTHCARE QUALITY THROUGH PERFORMANCE MEASUREMENT AND PUBLIC REPORTING. NQF IS A NOT-FOR-PROFIT MEMBERSHIP ORGANIZATION WITH MORE THAN 400 MEMBERS REPRESENTING VIRTUALLY EVERY SECTOR OF THE HEALTHCARE SYSTEM. NQF OPERATES UNDER A THREE-PART MISSION TO IMPROVE THE QUALITY OF AMERICAN HEALTHCARE BY SETTING NATIONAL PRIORITIES AND GOALS FOR PERFORMANCE IMPROVEMENT, ENDORSING NATIONAL CONSENSUS STANDARDS FOR MEASURING AND PUBLICLY REPORTING ON PERFORMANCE, AND PROMOTING THE ATTAINMENT OF NATIONAL GOALS THROUGH EDUCATION AND OUTREACH PROGRAMS. LINE 4A: STRATEGIC PARTNERSHIPS: NATIONAL PRIORITIES PARTNERSHIP (NPP) - THE NPP IS AN NQF-CONVENED COLLABORATION OF 52 PUBLIC- AND PRIVATE-SECTOR ORGANIZATIONS UNIQUELY QUALIFIED TO REPRESENT THE ARRAY OF STAKEHOLDERS NEEDED TO IMPROVE THE NATION'S HEALTHCARE SYSTEM. IN 2012, NPP FOCUSED ON HOW TO ADVANCE PATIENT SAFETY BY ALIGNING ITS WORK WITH HHS' "PARTNERSHIP FOR PATIENTS" EFFORT. NPP DEVELOPED ACTION PLANS TO FOCUS NATIONAL AND LOCAL ORGANIZATIONS IN DIVERSE SECTORS ON HOW TO ALIGN AROUND TWO GOALS: REDUCING PREVENTABLE READMISSIONS AND IMPROVING MATERNITY CARE BY REDUCING EARLY ELECTIVE DELIVERIES AND CESAREAN SECTION IN LOW-RISK WOMEN. NEARLY 700 INDIVIDUALS PARTICIPATED IN THESE ACTION-ORIENTED ACTIVITIES. NPP ALSO CREATED A WEB-BASED SYSTEM, THE ONLINE ACTION REGISTRY, TO TRACK AND SHARE THESE IMPROVEMENT ACTIVITIES AND TO ENABLE LEARNING ACROSS PARTICIPANTS. ALSO IN SUPPORT OF HHS' PARTNERSHIP FOR PATIENTS INITIATIVE, THE NPP DEVELOPED AND HOSTED THREE PATIENT-SAFETY ORIENTED WEBINARS IN 2012, AS WELL AS FOUR QUARTERLY IN-PERSON MEETINGS FOR A WIDE RANGE OF PARNERSHIP FOR PATIENTS STAKEHOLDERS. MEASURE APPLICATIONS - CONVENED BY NQF IN THE SPRING OF 2011, THE MEASURE APPLICATIONS PARTNERSHIP (MAP) IS A PUBLIC-PRIVATE PARTNERSHIP MADE UP OF 60 ORGANIZATIONS REPRESENTING MAJOR STAKEHOLDER GROUPS, 9 FEDERAL AGENCIES, AND 40 SUBJECT-MATTER EXPERTS. IT WAS ESTABLISHED TO PROVIDE HHS WITH THOUGHTFUL, PRE-RULEMAKING INPUT ABOUT WHICH PERFORMANCE MEASURES TO USE IN PUBLIC REPORTING AND PAYMENT WITHIN AND ACROSS 17 FEDERAL PROGRAMS. SIMULTANEOUSLY, MAP IS INFORMING THE THINKING AND DECISIONS OF PRIVATE-SECTOR LEADERS WITH RESPECT TO THEIR MEASURE-SELECTION STRATEGIES. MAP ENABLES PUBLIC- AND PRIVATE-SECTOR LEADERS TO WORK TOGETHER ON CREATING A MEASUREMENT STRATEGY AND IMPLEMENTATION PLAN THAT IS CROSSCUTTING AND COORDINATED ACROSS SETTINGS OF CARE; FEDERAL, STATE, AND PRIVATE PROGRAMS; LEVELS OF MEASUREMENT ANALYSIS; PAYER TYPE; AND POINTS IN TIME. IN FEBRUARY 2012, MAP SUBMITTED ITS FIRST ANNUAL PRE-RULEMAKING REPORT, PROVIDING PUBLIC/PRIVATE ADVICE TO HHS ABOUT USE OF MEASURES IN 17 DIFFERENT FEDERAL PROGRAMS. THE REPORT RECOMMENDED THAT 40 PERCENT OF THE MEASURES THAT CMS PROPOSED AT THE END OF 2011 MOVE INTO FEDERAL PROGRAMS; EXPRESSED CLEAR PREFERENCE FOR BOTH USING NQF-ENDORSED MEASURES AND FOR DEVELOPING MORE ROBUST FEEDBACK LOOPS; CONSIDERED HOW TO FURTHER ALIGN MEASURES ACROSS PROGRAMS AND WITH THE PRIVATE SECTOR; AND LAID OUT GUIDING PRINCIPLES FOR A THREE- TO FIVE-YEAR MEASUREMENT STRATEGY. THE CENTERS FOR MEDICARE & MEDICAID SERVICES LARGELY HEEDED THIS INPUT, WITH CMS' 2012 FINAL RULES IMPLEMENTING MANY OF THE MEASURES RECOMMENDED BY THE MAP (ON A PROGRAM BASIS, THE AGREEMENT OF RECOMMENDATIONS TO ACTUAL USE RANGED FROM 40 TO 100 PERCENT.) ALSO IN OCTOBER 2012, MAP RELEASED ITS FAMILIES OF MEASURES REPORT THAT DEFINES MEASURE FAMILIES IN FOUR KEY AREAS-SAFETY, CARE COORDINATION, CARDIOVASCULAR, AND DIABETES CARE-WITH THE GOALS OF PROMOTING MORE COHESION AND INTEGRATION OF CARE REGARDLESS OF SETTING, PROVIDER, LEVEL OF INTENSITY, OR TIMING, AS WELL AS REDUCING MEASUREMENT AND REPORTING BURDEN FOR HOSPITALS, PHYSICIANS, AND OTHER PROVIDERS. ORGANIZATION'S PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A CONTINUED & 4B LINE 4A CONTINUED: ROBERT WOOD JOHNSON FOUNDATION (RWJF) GRANT - THE STRATEGIC PARTNERSHIPS TEAM RELEASED THE QUALITY POSITIONING SYSTEM (QPS) VERSION 1.0, IN OCTOBER 2012. ORIGINALLY LAUNCHED IN BETA FORM IN 2011, QPS IS THE MOST RELIABLE AND COMPREHENSIVE ONLINE SOURCE FOR FINDING ALL NQF-ENDORSED MEASURES. QPS VERSION 1.0 ALLOWED USERS TO SEARCH FOR MEASURES; ORGANIZE MEASURES BY CREATING CUSTOMIZED LISTS OF NQF-ENDORSED MEASURES IN PUBLIC OR PRIVATE 'PORTFOLIOS' TO FIT SPECIFIC INTERESTS OR NEEDS; COMPARE MEASURES OR PORTFOLIOS SIDE-BY-SIDE; AND PRIVATELY SHARE PORTFOLIOS OR MEASURES OF INTEREST WITH OTHERS. SINCE THE BETA LAUNCH IN 2011, THOUSANDS OF USERS HAVE TESTED AND USED THE INTERACTIVE FEATURES. ALSO UNDER THE RWJF GRANT, IN FEBRUARY 2012 NQF RELEASED THE ALIGNMENT TOOL, AN EXCEL SPREADSHEET THAT DISPLAYS THE NQF-ENDORSED MEASURES IN USE BY ONE OR MORE OF THE 16 ALIGNING FORCES FOR QUALITY (AF4Q) ALLIANCES. THE TOOL HAS HELPED COMMUNITIES ALIGN THEIR MEASUREMENT STRATEGIES IN MULTIPLE WAYS: TO WHAT OTHERS ARE DOING, TO THE NATIONAL QUALITY STRATEGY PRIORITIES, AND TO NATIONAL PROGRAMS THAT INVOLVE REPORTING REQUIREMENTS OR PAYMENT INCENTIVES. THE TOOL LINKS TO QPS, WHERE UP-TO-DATE DETAILED MEASURE INFORMATION CAN BE FOUND. LINE 4B: PERFORMANCE MEASURES - THIS PROGRAMMATIC AREA REFERS TO THE TECHNICAL WORK OF EVALUATING PERFORMANCE MEASURES (PM) SUBMITTED FOR NQF-ENDORSEMENT CONSIDERATION. NQF COMPLETED 16 ENDORSEMENT PROJECTS DURING THE COURSE OF 2012, USING BOTH THE NATIONAL QUALITY STRATEGY (NQS) PRIORITIES THAT CROSS CONDITIONS AND LEADING HEALTH CONDITIONS WITH RESPECT TO PREVALENCE AND COST AS A WAY TO PRIORITIZE ITS EFFORTS. IN TOTAL, NQF COMMITTEES EVALUATED 430 SUBMITTED MEASURES AND ENDORSED 301. THESE ENDORSED MEASURES INCLUDE 81 NEW MEASURES AND 220 MEASURES THAT NQF EXPERT COMMITTEES CONCLUDED COULD MAINTAIN THEIR PREVIOUS ENDORSEMENT AFTER BEING REVIEWED AGAINST NQF'S CRITERIA AND COMPARED TO NEW EVIDENCE OR COMPETING MEASURES. OVERALL, MEASURES UNDERGOING MAINTENANCE WERE ENDORSED AT A RATE OF 55 PERCENT, AND NEW MEASURES SUBMITTED FOR ENDORSEMENT WERE ENDORSED AT A RATE OF 89 PERCENT. IN COMPARISON, NQF COMPLETED 11 PROJECTS AND ENDORSED 170 MEASURES IN 2011. THIS INCREASED PRODUCTIVITY CAN BE ATTRIBUTED TO EFFORTS TO MAKE THE REVIEW PROCESS MORE EFFICIENT-THE AVERAGE MEASURE REVIEW TIME DECREASED FROM 12 MONTHS TO 7 MONTHS DURING 2012-AS WELL AS TO OTHER ENHANCEMENTS TO THE ENDORSEMENT PROCESS. SPECIFICALLY, AS PART OF THE CONSENSUS DEVELOPMENT PROCESS PILOT PROGRAM, NQF PROVIDED EARLIER, MORE DETAILED FEEDBACK TO MEASURE DEVELOPERS ABOUT A FIRST-ORDER CRITERION (I.E., IMPORTANCE TO MEASURE) TO FURTHER THE GOAL THAT DEVELOPMENT DOLLARS ARE SPENT ON MEASURES THAT ARE VIEWED AS CONSEQUENTIAL BY THE FIELD. FURTHERMORE, WHEN A MEASURE IS RE-EVALUATED FOR CONTINUED ENDORSEMENT, NQF NOW REQUIRES COMMITTEES TO CONSIDER THE MEASURE'S USE AND WHETHER SUCH USE HAS RESULTED IN IMPROVEMENT OR HAS LED TO UNINTENDED CONSEQUENCES, ENSURING THAT COMMITTEE MEMBERS ARE INFORMED ABOUT THE MEASURE'S IMPACT. IN THE LAST YEAR, CLINICAL PROJECTS WITH A LARGE NUMBER OF PROCESS MEASURES HAD MARKEDLY LOWER ENDORSEMENT RATES FOR MAINTENANCE MEASURES (E.G., PERINATAL CARE, 44 PERCENT; PULMONARY, 44 PERCENT; AND RENAL DISEASE, 36 PERCENT). NEWER MEASUREMENT AREAS THAT ARE HIGHLY VALUED BY CLINICIANS AND PATIENTS HAD HIGHER ENDORSEMENT RATES, INCLUDING DISPARITIES MEASURES AT 75 PERCENT AND PALLIATIVE CARE AT 64 PERCENT. THE DISPARITIES MEASURES WERE PRIMARILY OUTCOME MEASURES, WHILE THE PALLIATIVE MEASURES WERE PRIMARILY PROCESS MEASURES. MEASURE HIGHLIGHTS FROM THE YEAR INCLUDE A FIRST-EVER SET OF RESOURCE USE MEASURES, HARMONIZED BEHAVIORAL HEALTH MEASURES, PATIENT-REPORTED EXPERIENCE MEASURES, READMISSIONS MEASURES THAT CAN HELP THE HEALTHCARE COMMUNITY BETTER UNDERSTAND AND APPROPRIATELY REDUCE READMISSION RATES, AND A MEASUREMENT FRAMEWORK FOR MULTIPLE CHRONIC CONDITIONS. ORGANIZATION'S PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4B CONTINUED & 4C & 4D LINE 4B CONTINUED: IN ADDITION TO THE MEASURES THAT WERE ENDORSED IN 2012, NQF ALSO REMOVED 103 MEASURES FROM ITS PORTFOLIO FOR A VARIETY OF REASONS: MEASURES NO LONGER MET ENDORSEMENT CRITERIA; MEASURES WERE HARMONIZED WITH OTHER SIMILAR, COMPETING MEASURES; OR MEASURE DEVELOPERS CHOSE TO RETIRE MEASURES THEY NO LONGER WISHED TO MAINTAIN. LINE 4C: HEALTH INFORMATION TECHNOLOGY: IN 2012, NQF LAUNCHED A SERIES OF ACTIVITIES DESIGNED TO PROMOTE SHARED UNDERSTANDING AMONG THOSE INVOLVED IN ADVANCING ELECTRONIC MEASUREMENT AND DATA INFRASTRUCTURE. SEVERAL OF NQF'S PROJECTS SOUGHT TO FACILITATE A UNIFIED UNDERSTANDING OF TERMS AND MEASUREMENT APPROACHES USED IN THE HEALTH IT FIELD, SO THAT MEASURE DEVELOPERS AND IMPLEMENTERS, HEALTH IT VENDORS, STANDARDS ORGANIZATIONS, AND OTHER USERS OF EMEASURES AND TOOLS WORK WITH A SIMILAR LEXICON. LINE 4C CONTINUED: E-MEASURES - NQF CONVENED THE EMEASURE LEARNING COLLABORATIVE, A NEW ENVIRONMENT FOR PROMOTING BEST PRACTICES RELATED TO DEVELOPMENT AND IMPLEMENTATION OF MEASURES APPLIED TO ELECTRONIC DATA SOURCES. EMEASURES ARE AN INNOVATION IN ADVANCING QUALITY MEASUREMENT, BUT SIGNIFICANT BARRIERS HAMPER THEIR WIDER SCALE CREATION, ADOPTION, AND USE. THROUGH TWO IN-PERSON MEETINGS AND OTHER VIRTUAL CONVENINGS, NQF BROUGHT TOGETHER HUNDREDS OF STAKEHOLDERS INCLUDING GOVERNMENT REPRESENTATIVES, EHR VENDORS, MEASURE DEVELOPERS, CLINICIANS, AND HOSPITALS-CREATING A UNIQUE FORUM FOR THESE PARTIES TO WORK TOGETHER ON NEW EMEASUREMENT APPROACHES. QUALITY DATA MODEL (QDM) - DEVELOPED BY NQF, THE QUALITY DATA MODEL (QDM) IS AN "INFORMATION MODEL" THAT DEFINES CONCEPTS USED IN QUALITY MEASURES AND CLINICAL CARE IN A WAY THAT ALLOWS THE INFORMATION TO BE COLLECTED AUTOMATICALLY FROM DATA ALREADY STORED IN AN EHR. NQF RELEASED AN UPDATED VERSION OF THE QDM IN DECEMBER 2012, WHICH FOCUSED ON SIMPLIFYING AND STANDARDIZING QDM MEASURE LOGIC TO SUPPORT IMPLEMENTATION OF THE FEDERAL MEANINGFUL USE REGULATIONS. NQF ALSO REGULARLY RECEIVES ONGOING FEEDBACK AND INSIGHTS INTO BEST PRACTICES FROM A USER GROUP OF MEASURE DEVELOPERS, PHYSICIANS, HOSPITALS, AND EHR VENDORS WHO ARE CURRENTLY ACTIVELY INVOLVED IN EMEASURE USE. MEASURE AUTHORING TOOL (MAT) - THIS NON-PROPRIETARY, WEB-BASED TOOL MAKES IT EASIER AND MORE EFFICIENT FOR MEASURE DEVELOPERS TO SPECIFY, SUBMIT, AND MAINTAIN ELECTRONIC MEASURES, OR EMEASURES. AT THE END OF 2012, NQF TRANSITIONED THE DAY-TO-DAY OPERATION OF THE MAT TO HHS, GIVING HHS THE OPPORTUNITY TO BETTER POSITION THE MAT AND EMEASURES IN FEDERAL PROGRAMS USING EHR-BASED PERFORMANCE MEASUREMENT, AND TO SUPPORT THE MAT'S EVOLUTION. CRITICAL PATHS FOR CREATING DATA PLATFORMS PROJECT - COMPLETED IN 2012, THIS EFFORT HELPED ASSESS THE READINESS OF ELECTRONIC DATA TO SUPPORT INNOVATIVE MEASUREMENT CONCEPTS AND RECOMMENDED STEPS TO ADDRESS DATA AND INFRASTRUCTURE GAPS AND BARRIERS IN TWO HIGH-PRIORITY DOMAINS: CARE COORDINATION AND PATIENT SAFETY. THE CARE COORDINATION REPORT FOCUSED ON TRANSITIONS OF CARE AND COMMUNICATION OF THE PATIENT PLAN OF CARE. THE PATIENT SAFETY REPORT FOCUSED ON EFFECTIVE USE OF INFUSION DEVICES (E.G., GIVING MEDICATION THROUGH AN IV) IN ACUTE CARE SETTINGS. THE ABILITY TO CAPTURE DATA ACROSS SETTINGS IS FUNDAMENTAL TO GAUGING, FOR EXAMPLE, THE DEGREE OF CARE COORDINATION IN A HEALTHCARE SYSTEM. THE FINAL REPORTS FROM THESE PROJECTS DELINEATED SPECIFIC STEPS THAT THE GOVERNMENT AND PRIVATE SECTOR CAN TAKE TO ENABLE ELECTRONIC MEASUREMENT IN THESE AREAS. LINE 4D: THE OTHER PROGRAM SERVICES INCLUDE CONFERENCES AND WORKSHOPS HELD BY NATIONAL QUALITY FORUM. MEMBERS OF ORGANIZATION AND MEMBERS VOTING RESPONSIBILITIES FORM 990, PART VI, LINE 6 AND LINE 7A LINE 6 THE NATIONAL QUALITY FORUM HAS OVER 400 MEMBER ORGANIZATIONS. THEY REPRESENT ALL SECTORS IN THE HEALTHCARE QUALITY LANDSCAPE INCLUDING: CONSUMERS; PUBLIC AND PRIVATE PURCHASERS; PHYSICIANS, NURSES, PHARMACISTS, AND OTHER HEALTHCARE PROFESSIONALS; HOSPITALS, NURSING HOMES, AND OTHER PROVIDER ORGANIZATIONS; ACCREDITING AND CERTIFYING BODIES; SUPPORTING INDUSTRIES; AND HEALTHCARE RESEARCH AND QUALITY IMPROVEMENT ORGANIZATIONS. LINE 7A MEMBERS VOTE ON A SLATE OF CANDIDATES TO FILL BOARD OF DIRECTOR VACANCIES. DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL FORM 990, PART VI, LINE 7B THE BOARD RECOMMENDS A SLATE OF CANDIDATES TO FILL BOARD VACANCIES. THIS RECOMMENDATION GOES TO THE GENERAL MEMBERSHIP FOR A VOTE. MEMBERSHIP MUST APPROVE CHANGES TO GOVERNING DOCUMENTS. FORM 990 REVIEW PROCESS FORM 990, PART VI, LINE 11A & 11B THE ORGANIZATION'S FORM 990 UNDERGOES A NUMBER OF INTERNAL AND EXTERNAL REVIEWS BEFORE IT IS FILED WITH THE IRS. THE RETURN IS PREPARED BY THE ORGANIZATION'S PUBLIC ACCOUNTING FIRM, BDO USA, AND IS THEN REVIEWED BY THE ORGANIZATION'S FINANCE AND AUDIT COMMITTEE, A COMMITTEE OF THE BOARD. A FINAL DRAFT OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS AND TO OUTSIDE COUNSEL FOR REVIEW AND COMMENT, BEFORE IT IS FILED WITH THE IRS. CONFLICTS OF INTEREST FORM 990, PART VI, LINE 12C ON AN ANNUAL BASIS, CONFLICT OF INTEREST FORMS ARE SENT TO BOARD MEMBERS AND STAFF TO COMPLETE. THE GENERAL COUNSEL REVIEWS CONFLICT OF INTEREST FORMS SUBMITTED BY BOARD MEMBERS AND BOARD MEMBERS ORALLY DISCLOSE ANY RELAVANT INFORMATION ANNUALLY IN A PUBLIC BOARD SESSION. EMPLOYEE CONFLICT OF INTEREST FORMS ARE SCREENED BY THE HUMAN RESOURCES DEPARTMENT AND ANY DISCLOSURES MADE BY EMPLOYEES ARE REFERRED TO THE GENERAL COUNSEL FOR FOLLOW-UP AND RESOLUTION. DETERMINING COMPENSATION FORM 990, PART VI, LINE 15A & 15B THE COMPENSATION COMMITTEE, COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS, DETERMINES THE CEO'S COMPENSATION PACKAGE BY USING COMPARABLE DATA APPROVED BY THE ENTIRE BOARD. CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION IS ALSO MAINTAINED. THE CEO DETERMINES THE SALARIES OF OTHER OFFICERS AND KEY EMPLOYEE BASED ON OUTSIDE COMPARABILITY DATA AND THE RESULTS ARE DOCUMENTED IN PERSONNEL FILES. AVAILABILITY OF OTHER DOCUMENTS FORM 990, PART VI, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.