Skip to Main Content

Quality Measures

Quality health care is a high priority for the President, the Department of Health and Human Services (HHS), and the Centers for Medicare & Medicaid Services (CMS). CMS implements quality initiatives to assure quality health care for Medicare Beneficiaries through accountability and public disclosure. CMS uses quality measures in its various quality initiatives that include quality improvement, pay for reporting, and public reporting.

What are Quality Measures?

Quality measures are tools that help us measure or quantify healthcare processes, outcomes, patient perceptions, and organizational structure and/or systems that are associated with the ability to provide high-quality health care and/or that relate to one or more quality goals for health care. These goals include: effective, safe, efficient, patient-centered, equitable, and timely care.

How are they developed?

For information on how CMS develops quality measures, please click on the "Measure Management System" link below for more information.

How are they used?

CMS uses quality measures in its quality improvement, public reporting, and pay-for-reporting programs for specific healthcare providers. Click on Related Links Inside CMS below for more information.

How are they collected or reported?

Data on quality measures are collected or reported in a variety of ways, such as claims, assessment instruments, chart abstraction, registries. Click on Related Links Inside CMS below for more information.

CMS is currently testing the submission of quality measures data from Electronic Health Records for physicians and other health care professionals and will soon be testing with hospitals. Click on the "Electronic Specification" link to the left for more information.

Where can I found out more about the measure specifications?

Measure specifications are available by clicking on Downloads or Related Links Inside CMS below.

Medication Measures Special Innovation Project

The Centers for Medicare & Medicaid Services (CMS) has contracted with FMQAI to provide services related to the Medication Measures Special Innovation Project.  The purpose of the project is to develop measures that can be used to support quality healthcare delivery to Medicare beneficiaries.  Specific project objectives include:

  1. Maintain previously developed medication measures and develop new medication measures with the potential for National Quality Forum (NQF)-endorsement;
  2. Adapt/specify existing NQF-endorsed medication measures and develop new measures for implementation in CMS reporting programs such as the Hospital Inpatient and Outpatient Quality Reporting Programs (IQR and OQR), the Physician Quality Reporting System (PQRS), and others as directed by CMS, such as long-term care settings and ambulatory care settings;
  3. Continue to develop new medication measures that address the detection and prevention of adverse medication-related patient safety events that can be used in future Quality Improvement Organization (QIO) SOWs and in CMS provider reporting programs; and
  4. Identify and specify up to 5 new adverse event measures (non medication-related) that could be used in future QIO programs and CMS provider reporting programs in the hospital setting (inpatient and/or emergency department).

In addition to maintenance of previously developed medication measures, the new measures to be developed under this special project will support QIO patient safety initiatives by addressing topics such as the detection and prevention of medication errors, adverse drug reactions, and other medication-related patient safety events.  Under this special project, existing medication measures, as well as new medication measures, shall be refined and specified for implementation in provider reporting programs.

The project currently has a portfolio of 6 NQF-endorsed measures for the ambulatory care setting. 

  • NQF-0542: Adherence to Chronic Medications (Statins/ACEIs and ARBs/Levothyroxine)
  • NQF-0543: Adherence to Statin Therapy for Individuals with Coronary Artery Disease
  • NQF-0545: Adherence to Chronic Medications for Individuals with Diabetes Mellitus
  • NQF-0555: Lack of Monthly INR Monitoring for Individuals on Warfarin
  • NQF-0556: INR for Individuals Taking Warfarin and Interacting Anti-infective Medications
  • NQF-1879: Adherence to Antipsychotic Medications for Individuals with Schizophrenia

The maintenance of these measures requires the specifications to be updated annually; the specifications are provided in the “Downloads” section below.