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Public Comment

Welcome to CMS Quality Measures Public Comment Page

This page serves as the designated site for CMS to solicit public comments on proposed quality measures that are included in the individual project pages. The public comment period provides an opportunity for the widest array of interested parties to provide input on the measures under development and can provide critical suggestions not previously considered by the measure contractor or its technical expert panel (TEP).

Details of the Public Comment Period:

  • The public is encouraged to submit general comments relevant to both measures or comments specific to certain measures
  • Information about each measure is found in the Downloads section below
  • Do not include personal health information in your comments
  • At the end of the public comment period, all public comments will be posted on the website along with a public comment summary report

Instructions for Providing Comments:

  • If you are providing comments on behalf of an organization, include the organization’s name and your contact information
  • If you are commenting as an individual, submit identifying or contact information
  • Please indicate which measure(s) you are commenting on
  • You may submit general comments on the entire set of measures or you may provide comments specific to individual measures

Public Comment Postings:

  • Development of Nursing Home Five-Star Measures
  • Electronic Specifications for the Core Clinical Data Elements for Risk Adjustment of Hospital-Level Outcome Measures

 

Project Title:  Development of Nursing Home Five-Star Measures

Dates: 

  • The Call for Public Comment period opens on May 11, 2015 and closes on May 29, 2015.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has contracted with RTI International to develop new candidate quality measures for nursing homes to be used in CMS’s nursing home five-star rating program. The contract name is Development and Maintenance of Symptom Management Measures. The contract number is HHSM-500-2008-000211. As part of its measure development and maintenance process, CMS requests interested parties to submit comments on the candidate measures that may be suitable for this project.

Project Objectives:

To develop new measures that assess nursing home quality. Development of measures includes conducting statistical testing to determine the specifications for the numerator and denominator, to identify exclusion criteria, and to adjust for resident characteristics associated with outcomes.

To help achieve these objective, CMS and RTI International solicit public comments on the following candidate nursing home quality measures:

  • Percentage of Residents Whose Ability to Move In and Around Their Room and Adjacent Corridors Declined (Long Stay).
  • Prevalence of Antianxiety or Hypnotic Medication Use (Long Stay)
  • Percentage of Residents Who Developed Delirium after Admission and were Discharged with Symptoms (Short Stay)
  • Percentage of Residents with Functional Improvement (Short Stay)

Documents and Measures for Comment:

To inform your comments, you can review the measure specifications for each of the four candidate measures in the following documents found below in the Download section (NH 5-Star Public Comment Posting.zip).

  • NH 5-Star Public Comment Posting_LS Locomotion_05012015.pdf
  • NH 5-Star Public Comment Posting_LS Antianxiety Hypnotic Med Use _05012015.pdf
  • NH 5-Star Public Comment Posting_SS Functional Improvement_05012015.pdf
  • NH 5-Star Public Comment Posting_SS Delirium_05012015.pdf

Project Specific Instructions:

  • Do not include personal health information in your comments.
  • If you are providing comments on behalf of an organization, include the organization’s name and your contact information.
  • If you are commenting as an individual, submit identifying or contact information.
  • Please indicate which measures you are providing comments on. You may submit general comments on the entire set of measures or you may provide comments specific to individual measures.
  • Send your comments to  CMSNursingHomeQM@rti.org
  • Comments are due by May 29, 2015 at midnight [12:00AM EST].

 

Project Title: Electronic Specifications for the Core Clinical Data Elements for Risk Adjustment of Hospital-Level Outcome Measures

Dates: 

  • The Call for Public Comment period opens on April 27, 2015 and closes on June 16, 2015.

Project Overview: 

The Centers for Medicare & Medicaid Services (CMS) has a contract with Yale New Haven Health Services Corporation Center for Outcomes Research & Evaluation (CORE) to develop the core clinical data elements, a set of 21 clinical variables from electronic health records (EHR) that are routinely collected and can be feasibly extracted for use in risk-adjusted hospital-level outcome measures. The contract name is: Development, Reevaluation, and Implementation of Hospital Outcome/Efficiency Measures; Contract Number: HHSM-500-2013-13018I- T0001 Modification 000002. CMS envisions using core clinical data elements in conjunction with other sources of data, such as administrative claims-based data, to calculate “hybrid” outcome measures, which are hospital quality measures that utilize more than one source of data.

CORE worked with Mathematica Policy Research to electronically specify the core clinical data elements. As part of its measure development process, CMS requests interested parties to submit comments on the electronic specifications and value sets for the core clinical data elements. We also ask that comments focus on technical aspects of the electronic specifications as opposed to comments focusing on policy related issues or concerns associated with the implementation of core clinical data elements. Specifically, we are looking for comments on the:

  • Ease of electronically extracting these data from an electronic health record (EHR) without the need for manual abstraction;
  • Measure logic (i.e., the clarity and specificity of the instructions for obtaining data to be reported); and
  • Appropriateness of codes contained in value sets for identifying relevant encounters and first captured clinical data during a clinical encounter.

Project Objectives: 

  • To create valid and easily interpreted electronic specifications with Quality Data Model (QDM) elements that will facilitate accurate extraction of the core clinical data elements from the most currently operating EHRs.

Documents and Measures for Comment: 

The following documents are provided for your review and comment. The files are found below in the Download section.

  • Overview of the purpose for the core clinical data elements
  • Human-readable header and logic from the Measure Authoring Tool (MAT)
  • Value set Object Identifiers (OIDs)

Project Specific Instructions: 

  • Please note this public comment period is for feedback on the electronic specifications and value sets for the core clinical data elements only. For comments on the use of data elements from EHRs in specific quality measures, comments on the FY 2016 IPPS/LTCH proposed rule, or policy concerns related to implementation of the core clinical data elements, please submit feedback from April 30 – June 16, 2015 here: http://www.regulations.gov/#!docketDetail;D=CMS-2015-0049. Within the document, search for the section “Future Considerations for Electronically Specified Measures: Consideration to Implement a New Type of Measure that Utilizes Core Clinical Data Elements”, pages 1060 – 1075.
  • Do not include patient level or personal health information in your comments.
  • If you are providing comments on behalf of an organization, include the organization’s name and your contact information.
  • If you are commenting as an individual, submit identifying or contact information.
  • The JIRA comment tool will be used to collect comments on the core clinical data element specifications listed above. Please use the following links to submit your comments:

If you are a current JIRA user with an active account:

http://jira.oncprojectracking.org

(Select “Log In” at the top right corner)

If you are new to JIRA and do NOT have an account:

http://jira.oncprojectracking.org/login.jsp

(Select “Sign up” to set up a new account and log into the JIRA tool)

Once logged into the JIRA tool:

  1. Select “Projects” at the top middle of the home screen.
  2. Select “View all Projects”
  3. Under Quality-Measures, select “Core Clinical Data Elements Electronic Specifications – Public Comments”
  4. To enter comments, select “Create issue” (Orange button) at the top middle of the screen.
  5. Select the type of issue from the “Issue type” drop-down menu.
  6. Please fill out the fields labeled: “Summary,” “Contact name,” “Contact email,” and “Contact phone.”
  7. Enter your comments in the “Description” field. There is a 1,800 character limit. If you exceed that limit, your comment will be cut off at 1,800 characters.
  8. Select “Create” at the bottom left to submit your comments. If you would like to enter more comments, select “Create another” and then “Create.”