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Call for Measures

As a part of its measure development process, CMS may request interested parties to submit candidate measures that may be suitable for a specific project. The candidate measures suggested will be reviewed by CMS and its measure development contractor(s). Candidate measures suggested through a call for candidate measures will undergo the same rigorous evaluation as all CMS measures.

The CMS measures development process consists of the following steps:

  • Identifying important quality goals related to Medicare services
  • Conducting literature reviews and grading evidence
  • Defining and developing specifications for each quality measure
  • Obtaining evaluation of proposed measures by technical expert panels
  • Soliciting public comment on proposed measures
  • Testing measures for validity, reliability, ease, and accuracy of collection
  • Refining measures as needed

Project Overview: ARRA HITECH Eligible Professionals Clinical Quality Measures Project

Patient and Family Engagement and Care Coordination Measures Environmental Scan

The Centers for Medicare & Medicaid Services (CMS) are developing a portfolio of electronically-specified clinical quality measures (eCQMs) that can be reported by participating Eligible Professionals (EPs) through CMS quality reporting programs. CMS has contracted with Mathematica Policy Research to identify promising eCQM concepts for patient and family engagement and care coordination measures applicable to both primary care physicians (PCPs) and specialists. As part of its measure development process, CMS is requesting that interested parties submit candidate concepts and/or measures that may be suitable for reporting by EPs, particularly those appropriate for developing into de novo outcomes measures. Specifically, CMS seeks to identify measures in the domains of:

  • Prevention and screening 
  • Efficiency of care
  • Behavioral health, and
  • Measures applicable to patients with multiple chronic conditions

Patient and Family Engagement

Candidate patient and family engagement measures or concepts should have the potential to improve patient- and family-centered care, the quality of care delivered to patients, and the inclusion of caregivers in the delivery of care.  Some examples of patient and family engagement concepts, to name only a few, include patient-reported outcomes, patient-provider communications, and shared decision-making. An example of a patient and family engagement measure is: percentage of patients aged 65 years and older with heart failure who completed initial and follow-up patient-reported functional status assessments. In addition to measure concepts, an interested party could suggest a measure used in a different setting, such as hospitals or nursing homes, that could be adapted for use in ambulatory care by EPs.

Care Coordination

Candidate care coordination concepts or measures can address issues such as timely sharing of information and coordination of clinical processes and services. Some examples of care coordination concepts, to name only a few, include care transitions and the continuum of care, bi-directional primary care and specialty provider communications, test result and treatment follow-up, and referral follow-up. In addition to measure concepts, an interested party could suggest a measure used in a different setting, such as hospitals or nursing homes, which could be adapted for use in ambulatory care by EPs.

The National Quality Forum (NQF) recently conducted a call for measures related to care coordination; a list of these measures is posted on the NQF website at the following link:  http://www.qualityforum.org/Prioritizing_Measure_Gaps_-_Care_Coordination.aspx.

Please suggest any measures or concepts related to ambulatory care that have not been previously submitted to the NQF.

The patient and family engagement and care coordination candidate measures and concept recommendations provided will be reviewed by CMS, the measure development contractor, and potentially a technical expert panel convened by the measure contractor. Any measures and concepts prioritized during this process will be developed into de novo eCQMs. Any measure(s) adapted or adopted for inclusion in CMS programs will reside in the public domain.

Objective:

The primary objective of this call for measures is to identify and compile existing patient and family engagement and care coordination measures and/or measure concepts being developed or used by stakeholders. Measures and concepts will be reviewed and analyzed for potential development into eCQMs.

Instructions:

When submitting measures and/or concepts for consideration, please include all required documentation following the instructions below:

  1. Submit the candidate measures and/or concepts on the “Measures Submitted for Consideration” form available in the download section. If you are submitting fully developed or endorsed measures, attach any additional measure information to the email.
  2. Email the completed form and any attachments to: e-measures@mathematica-mpr.com
  3. All submissions must be received by Friday, September 19, 2014 5pm ET

 

CMS is Accepting Suggestions for Potential Physician Quality Reporting System Measures and/or Measures Groups

The Centers for Medicare & Medicaid Services (CMS) is accepting quality measure suggestions for potential inclusion in the proposed set of quality measures in the Physician Quality Reporting System for future rule-making years. Quality measures submitted in this Call for Measures also will be considered for use in other quality programs for physicians and other eligible professionals (e.g. Value Based Modifier, Physician Compare, Medicare Shared Savings Program, etc.).

Beginning this year, the Call for Measures will be conducted in an ongoing open format. Unlike previous years, where the annual Call for Measures closed after a specified period of time, the Call for Measures for 2014 will remain open indefinitely. The month that a measure is submitted for consideration will determine when it may be included on the Measures Under Consideration (MUC) list. Measures submitted from May 1, 2014 to June 30, 2014 may be considered for inclusion on the 2014 MUC list for implementation in PQRS as early as 2016. Measures submitted after June 30, 2014, may be considered for inclusion on the 2015 MUC list for implementation in PQRS as early as 2017.

Each measure submitted for consideration must include all required supporting documentation. Measure submissions that name a measure steward other than the organization submitting the potential measure must include documentation that the measure steward has agreed to maintain the measure if it is accepted. Submissions missing documentation of the steward's commitment to maintain a proposed measure will be automatically eliminated from the measure review process.

Documentation requirements and the schedule of cut-off dates for the yearly MUC list inclusion are posted in the Downloads section below. Only those measures submitted in the provided format will be accepted for consideration. Questions about this Call for Measures or the required documentation may be submitted to C4M@wvmi.org.

When submitting measures for consideration, please ensure that your submission is not duplicative of another existing or proposed measure. Submitted measures must be further along in development than a measure concept. Additionally, CMS is not accepting claims-based only reporting measures in this process. CMS is seeking a quality set of measures that are outcome-based rather than clinical process measures. Other measure types that CMS is interested in include measures of patient safety and adverse events, appropriate use of diagnostics and therapeutics, care coordination and communication, patient experience and patient-reported outcomes and measures of cost and resource use.

Measures submitted for consideration will be assessed to ensure that they meet the needs of the Physician Quality Reporting System. As time permits, feedback will be provided to measure submitters upon review of their submission.

Note: Suggesting individual measures or measures for a new or existing measures group does not guarantee the measure(s) will be included in the proposed or final sets of measures of any Proposed or Final Rules that address the Physician Quality Reporting System. Additionally, measures submitted for consideration are not guaranteed to be put forth on the MUC list. CMS will determine which individual measures and measures group(s) to include in the proposed set of quality measures, and after a period of public comment, the agency will make the final determination with regard to the final set of quality measures for the Physician Quality Reporting System.