Clinical Quality Measures (CQMs)

Clinical quality measures, or CQMs, are tools that help us measure and track the quality of healthcare services provided by eligible professionals (EPs), eligible hospitals (Ehs) and critical access hospitals (CAHs) within our health care system. These measures use a wide variety of data that are associated with a provider’s ability to deliver high-quality care or relate to long term goals for health care quality. CQMs measure many aspects of patient care including: health outcomes, clinical processes, patient safety, efficient use of healthcare resources, care coordination, patient engagements, population and public health, and clinical guidelines.

Continuously measuring and reporting these CQMs helps to ensure that our health care system can deliver effective, safe, efficient, patient-centered, equitable, and timely care.

Currently, in Stage 1 of meaningful usefor the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, CQMs are required as a core meaningful use objective. EPs, EHs and CAHs who wish to participate in the EHR Incentive Program must submit data from certified EHR Technology CQMs in order to receive an incentive payment in the EHR Incentive Program. In Stage 2, CQMs are no longer a core meaningful use objective; however, EPs, EHs and CAHs are still required to submit CQMs in order to successfully participate in the program.

Beginning in 2014, all providers, regardless of whether they are in Stage 1 or Stage 2 of meaningful use, will be required to report on the 2014 CQMs finalized in the Stage 2 rule. CMS has also provided information on what to report in 2013 as well as how to begin the transition for reporting in 2014. In addition, beginning in 2014, all EPs and EHs beyond their first year of meaningful use will be required to submit CQMs electronically. To learn more about electronic reporting please visit the Electronic Reporting Specification page of the EHR Incentive Program.

Reporting in 2012 and 2013

EPs, eligible hospitals and CAHs are required to submit CQM results as calculated by certified EHR technology. In 2012 and 2013, there will be two options for CQM reporting:

• Attestation
• Electronic Reporting Pilots
  • EPs - through PQRS
  • Eligible hostpitals and CAHs - through QualityNet

Please note, requirements for reporting in 2013 will remain the same as in previous years. Please visit the 2013 EHR Incentive Program page for more information.

For information on the 2014 Clinical Quality Measures for the EHR Incentive Program, please visit the 2014 CQM Page.

To access the EHR Incentive Program 2014 CQM electronic specifications please visit the eCQM Library page.