The Center for Consumer Information & Insurance Oversight
Multi-Stakeholder Group Input on Quality Measures
Section 3014 of the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act) (P.L. 111‐148 and P.L. 111‐152) requires the establishment of a federal "pre‐rulemaking process" for the selection of quality and efficiency measures for specific qualifying programs within the Department of Health and Human Services (HHS). This process includes:
- Making publicly available, by December 1st annually, a list of measures currently under consideration by HHS for qualifying programs within the Department, including measures suggested by the public;
- Providing the opportunity for multi‐stakeholder groups to review and provide input by February 1st annually to HHS on the measures under consideration, and for HHS to consider this input;
- Publishing the rationale for the selection of any quality and efficiency measures that are not endorsed by the National Quality Forum (NQF); and
- Assessing the impact of endorsed quality and efficiency measures at least every three years (the first report due to the public by March 1, 2012).
CMS is working to streamline quality measures
CMS is issuing this list in fulfillment of a statutory requirement to publicly present measures it is considering for adoption in the following year, including measures suggested by the public. Accordingly, it is a much larger list than will ultimately be adopted for optional or mandatory reporting programs in Medicare, Medicaid, and the Children's Health Insurance Program.
CMS will continue its goal of aligning measures across programs, including establishing "core" measure sets using existing program measures for new programs (e.g., establishing a core hospital measure set for the Hospital Value‐based Purchasing Program using measures that were previously implemented in the Hospital Inpatient Quality Reporting Program). Similarly, CMS will also work to align across core sets (e.g., for meaningful use and other programs) when possible within statutory requirements.
Further, CMS programs must balance competing goals of establishing parsimonious sets of measures, while including sufficient measures to facilitate provider participation (for example, the PQRS and the Medicare and Medicaid EHR Incentive Program, which together include the bulk of the measures under consideration included in this list (284 measures), are included at the request of physician specialty groups to allow their full participation in the programs).
Multi-Stakeholder Group Feedback
CMS has submitted the list of measures under consideration for calendar year 2012 to the NQF-convened Measure Applications Partnership (MAP) for its review and feedback. To view the CMS list of measures, the MAP review process and opportunities for the public participation in that process, and ultimately the final MAP feedback, please visit the NQF MAP webpage at www.qualityforum.org/MAP.
Please direct questions regarding the ACA 3014 pre-rulemaking process and the CMS list of measures to Edward Garcia, CMS/OCSQ (410-786-6738).
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