As with other types of measures, the resource use measure evaluation criteria use the criteria in the Partnership for Quality Measurement (PQM) Endorsement and Maintenance Guidebook on the PQM website. Measure developers should keep the major evaluation criteria in place, but modify any subcriteria, as appropriate, to reflect the specific needs of resource use measure evaluation.

Resource use measures are broadly applicable and comparable measures of input counts (i.e., in terms of units or dollars) applied to a population or population sample. Resource use measures count the frequency of specific resources. The measure developer should monetize these resource units as appropriate. The approach to monetizing resources varies and often depends on the perspective of the measurer and the measured. Monetizing resource use permits aggregation across resources.

Considerations for evaluating resource use measures include

• Specifications for resource use measures should be well defined, complete, and precise.
• Specifications should include measure clinical logic and method, measure construction logic, and adjustments for comparability as relevant to the measure.
• Data protocol steps are critical to the reliability and validity of the measure.
• Examples of evidence a numerator and/or denominator exclusion distorts measure results include, but not limited to, frequency or cost of occurrence, sensitivity analyses with and without the exclusion, and variability of the exclusion across measured entities.
• Some measures may specify the exclusion of some patients, events, or episodes known or determined to be high cost. For example, a chronic obstructive pulmonary disease resource use measure may exclude a patient with active cancer because measure developers consider cancer the dominant medical condition with known high costs.
• Testing for resource use measure exclusions should address the appropriate specification steps (i.e., clinical logic, thresholds, and outliers).
• When the measure developer does not address exclusions, they must justify this decision and describe the corresponding implications.

Key Points

Measure developers can use measures of cost and resource use to assess variability of the cost of health care. Policy makers may use cost and resource measures to direct efforts to make health care more affordable. When developing specifications for cost and resource measures, measure developers should consider the types of data required, the time periods relevant to the measures, and which patients, procedures, or conditions to include in the measurement. In the context of measure reporting, health care payers and program administrators use cost and resource measures to attribute the monetary value of care provided as part of an episode of illness, care of a population, and event to a measured entity, in combination with quality or health outcome performance. During the process of measure evaluation, measure developers must ensure measures are well defined, complete, and precisely specified.