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CMS Streamlines Clinical Quality Measure Reporting Guidelines

CMS, along with industry stakeholder groups, has streamlined clinical quality measure reporting guidelines into seven simple categories.

By Sara Heath

The Centers for Medicare & Medicaid Services (CMS), in partnership with several industry stakeholders and provider groups, have developed a set of streamlined and simplified clinical quality measures reporting requirements.

According to a public statement out of CMS, the agency partnered with America’s Health Insurance Plans (AHIP) to develop seven core clinical quality measures (CQM) standards that align with several federal healthcare initiatives.

These measures, which support a multiple kinds of payers, were developed through the Core Quality Measures Collaborative to allow providers to report quality measures to multiple payers and programs, eliminating the need for them to report those measures multiple times to multiple sources. This in turn should increase the volume and the quality of the reporting.

The core measures are in the following seven categories:

  • Accountable Care Organizations (ACOs), Patient Centered Medical Homes (PCMH), and Primary Care
  • Cardiology
  • Gastroenterology
  • HIV and Hepatitis C
  • Medical Oncology
  • Obstetrics and Gynecology
  • Orthopedics

CMS reportedly expects this streamlining of CQM reporting will increase quality of care or patients and efficiency for providers, keeping up with the overall shift to value-based care.

“In the U.S. Health care system, where we are moving to measure and pay for quality, patients and care providers deserve a uniform approach to measure quality,” said CMS Acting Administrator Andy Slavitt. “This agreement today will reduce unnecessary burden for physicians and accelerate the country's movement to better quality.”

This process is still ongoing, and CMS says that it will be releasing more measure sets and updates in the future. Going forward, public and private payers will work together to make quality reporting and quality care more feasible for providers.

“Members of the Collaborative have taken a leadership role in identifying measures that will drive quality improvement and outcomes for patients,” said AHIP’s executive vice president Carmella Bocchino. “This is a first step of an ongoing process to ensure both public programs and the private sector align measures and reporting especially as we advance alternative payment models.”

Provider groups expressed their support for this move, saying that it will help their constituents provide quality care to patients.

“We are acutely aware of the huge amount of administrative complexity and burden that impacts the daily work of our members and diverts time and resources away from direct patient care,” said executive vice president and CEO of the American Academy of Family Physicians Douglas E. Henley, MD. “A major part of this is the burden of multiple performance measures in quality improvement programs with no standardization or harmonization across payers. This agreement on a set of core measures for primary care and the PCMH represents a big step toward the goal of administrative simplification for family physicians and improved quality of care.”

Other provider groups agreed. According to Debra L. Ness from the National Partnership for Women & Families, this streamlining of clinical quality measures will help make information more patient-centered.

“We need measurement that works for clinicians and helps them improve care, while also providing information that is meaningful and actionable for patients and families,” Ness noted. “Alignment across payers is key to making sure measurement doesn't waste resources or create unnecessary burden. Ultimately, it plays a foundational role in achieving better health and better health care at lower costs.”

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