CMS Finalizes Its Quality Measure Program

May 5, 2016
Officials at CMS on Tuesday posted the agency’s finalized Quality Measurement Program on its website, focusing on identifying known measurement and performance gaps and developing measures in six key quality “domains”

Senior officials at the federal Centers for Medicare & Medicaid Services (CMS) on Tuesday posted the agency’s finalized Quality Measurement Program (QMP) on its website. In posting the announcement, Kate Goodrich, M.D., director of the Center for Clinical Standards & Quality at CMS, said in a statement the following: “CMS aims to drive improvement in our national health care system through the use of quality measures and periodic assessment of the impact of such measurement. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established payment incentives for physicians and other clinicians based on quality, rather than quantity, of care. We recently released the proposed regulation to implement these payment incentives, and more information is available here: https://federalregister.gov/a/2016-10032. The Quality Measure Development Plan is an essential aspect of this transition, which will provide the foundation for building and implementing a measure portfolio to support the quality payment programs under MACRA.”

According to the announcement, highlights from provider comments that the agency had received on its draft plan included the following:

>  Many commenters expressed support for the strategic approach of the Quality Measure Development Plan.

>  Responses favored CMS’ intent to engage clinicians, medical societies, and other stakeholders more broadly in measure identification, selection, and development processes for MIPS and APMs.

>  Professional associations representing diverse clinical practice areas identified current measurement gaps and proposed priorities for measure development that are directly applicable to their specialties.

>  Consumer advocates urged CMS to partner with patients, families, and caregivers and recommended a model for engaging them in measure development.

>  Many commenters approved of the approach envisioned by the National Testing Collaborative and the National Quality Forum (NQF) Incubator to promote early engagement of stakeholders in measure development and testing.

>  Both organizations and individuals contributed insights into the integral roles of their clinical professions or practices in the U.S. health care delivery system.

Given those kinds of comments, Dr. Goodrich said in the announcement that “CMS finalized the Quality Measure Development Plan to include

>  Identification of known measurement and performance gaps and prioritization of approaches to close those gaps by developing, adopting, and refining quality measures, including measures in each of the six quality domains:

o             Clinical care

o             Safety

o             Care coordination

o             Patient and caregiver experience

o             Population health and prevention

o             Affordable care

>  CMS actions to promote and improve alignment of measures, including the Core Quality Measures Collaborative, a work group convened by America’s Health Insurance Plans (AHIP). On February 16, 2016, CMS and the Collaborative announced the selection of seven core measure sets that will support multi-payer and cross-setting quality improvement and reporting across our nation’s health care systems.

>  Partnering with frontline clinicians and professional societies as a key consideration to reduce the administrative burden of quality measurement and ensure its relevance to clinical practices.

> Partnering with patients and caregivers as a key consideration for having the voice of the patient, family, and/or caregiver incorporated throughout measure development.

>  Increased focus and coordination with federal agencies and other stakeholders to lessen duplication of effort and promote person-centered health care.”

As Dr. Goodrich went on to state, “The MACRA law [the Medicare Access and CHIP Reauthorization Act of 2015] provides the opportunity to further progress the Medicare program and our national health care system toward paying for value rather than volume.  However, the successful implementation of the Quality Payment Program established by MACRA requires a partnership with patients, their families, frontline clinicians, and professional organizations to develop measures that are meaningful, applicable, and useful across payers and health care settings. We thank all who contributed comments and dialogue to the draft CMS Quality Measure Development Plan, and we look forward to partnering with you on these exciting efforts related to our quality payment programs.”

Sponsored Recommendations

The Healthcare Provider's Guide to Accelerating Clinician Onboarding

Improve clinician satisfaction and productivity to enhance patient care

ASK THE EXPERT: ServiceNow’s Erin Smithouser on what C-suite healthcare executives need to know about artificial intelligence

Generative artificial intelligence, also known as GenAI, learns from vast amounts of existing data and large language models to help healthcare organizations improve hospital ...

TEST: Ask the Expert: Is Your Patients' Understanding Putting You at Risk?

Effective health literacy in healthcare is essential for ensuring informed consent, reducing medical malpractice risks, and enhancing patient-provider communication. Unfortunately...

From Strategy to Action: The Power of Enterprise Value-Based Care

Ever wonder why your meticulously planned value-based care model hasn't moved beyond the concept stage? You're not alone! Transition from theory to practice with enterprise value...