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CMS Announces Updates to Clinical Quality Measures

In a recent announcement, CMS updated 2016 electronic clinical quality measures, which will be used by healthcare providers looking to demonstrate meaningful use.

By Jacqueline LaPointe

CMS has recently updated the 2016 electronic clinical quality measures (eCQMs) for eligible hospitals and healthcare professionals for the 2017 reporting period. Many of the eligible hospitals and professionals will be able to use the new eCQMs to demonstrate meaningful use for EHR Incentive Programs.

In this year’s update, there are 29 new quality measures for eligible hospitals and 64 new quality measures for eligible healthcare professionals.

QDM 2.3 based-HQMF version R 2.1 was used to re-specify the updated eCQMs.

For eligible healthcare providers who are using the new eCQMs to illustrate meaningful use for EHR Incentive Programs, CMS noted that it will “accept all versions of the eCQMs through attestation, beginning with those finalized in the December 4, 2012 CMS-ONC Interim Final Rule.”

CMS also stated that eligible hospitals, healthcare professionals, and Critical Access Hospitals must employ the most current version of eCQMs for electronically reporting to Quality Reporting Programs or to demonstrate meaningful use.

To ensure systems can report eCQMs, CMS suggested that healthcare providers verify that their health IT systems can capture or map to approved codes.

“The vocabulary value sets used by eCQMs consist of codes and terms drawn from standard vocabularies such as SNOMED CT®, RxNorm, and ICD-10-CM to represent the clinical concepts found in EHR patient data as defined by the eCQMs (e.g., patients with diabetes, clinical visit),” explained CMS.

CMS revises the list of eCQMs each year to ensure that quality reporting measures align with current clinical guidelines and code systems. The updates include new codes, logic corrections, and clarifications, according to CMS.

The quality measures are evaluated against patient and family engagement, patient safety, care coordination, population and public health, efficient use of healthcare resources, and clinical processes and effectiveness.

Quality measures are becoming increasingly important as payment structures transition from fee-for-service to value-based models. Healthcare providers must demonstrate value-based care and quality improvement in their organizations in order to get paid.

However, some industry groups do not agree with how healthcare providers report eCQMs to CMS.

The American Medical Informatics Association recently submitted comments to CMS asking the agency to completely overhaul its eCQMs reporting guidelines. The comments stated that the emphasis on EHR certification and the large number of required measures takes away from improving patient care.

Additionally, the Medical Group Management Association released a statement criticizing the reporting system for clinical quality measures. The group explained that healthcare providers are spending billions of dollars on quality measures even though most measures are not clinically relevant.

Despite annual updates, clinical quality measures and reporting is still a major concern between healthcare stakeholders and payers. 

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