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CMS Measures Management System

CMS Measures Management System

The Centers for Medicare & Medicaid Services (CMS) has developed a standardized system for developing and maintaining the quality measures used in its various quality initiatives and programs. Known as A Blueprint for the Measures Management System, CMS-funded measure developers (or contractors) should follow these core processes developing, implementing, and maintaining quality measures. The primary goal of the Blueprint is to inform measure developers how to produce high-caliber quality measures that are appropriate for accountability. The latest version of the Blueprint (Version 11), documents the full Measures Management System core set of business processes.

Though the Blueprint receives a comprehensive annual update by the Measures Manager, continuous improvements are incorporated in quarterly updates as needed. The Measures Manager solicits feedback and suggestions from the end users of the Blueprint. One simple way to ask questions and submit feedback or suggestions is to e-mail the Measures Manager at

CMS Measures Management System Blueprint (the Blueprint) v 11.0

The Blueprint is divided into four sections. The first section contains measure development concepts, the second describes procedural steps for measure development and maintenance, the third covers procedural information specific to eMeasures, and the fourth is a collection of tools and forms to be used during the measure lifecycle. Below is a more detailed explanation of each section of the Blueprint:

Section 1—Measure Development Concepts—covers concepts that apply throughout the measure lifecycle and provides background and a more in-depth description of those concepts. This material is not repeated in the procedure sections but is referenced wherever applicable.

Section 2—Measure Lifecycle—describes the procedural steps necessary to develop and maintain a measure.

Section 3—eMeasure Lifecycle—is constructed parallel to Section 2 because it also describes measure development and maintenance procedures, but material in this section is specific to eMeasures. The section references conceptual material from Section 1 and procedural material from Section 2 where they apply to eMeasures.

Section 4—Tools, Appendices, and Forms—contains all of the tools, appendices, and forms referenced in the Blueprint. It also contains a glossary and a list of acronyms used in the Blueprint.

The Blueprint is now designed primarily as an electronic document with navigation bookmarks and internal and external hyperlinks. Resources and forms are referenced throughout the Blueprint where they are required, and key terms are linked to their appropriate glossary entries. Any text formatted in blue represents an internal or external hyperlink.

Significant Changes in Version 11, July 2014

Most changes in Version 11 were minor editorial clarifications and corrections. The more significant changes included:

  • Adding the CMS Quality Strategy, and how it relates to the National Quality strategy, including a crosswalk between the two.
  • Added Risk Adjustment material to chapter 2 Measure Specification that describes procedures for risk adjustment, used only with outcome measures, and when measure specifications are being developed.
  • Greatly expanded the description of Patient Engagement and Participation, adding material on: 
    1. Recruitment
    2. Planning
    3. Confidentiality
    4. Meeting support
    5. Other innovations from various process improvement events in the past year.
  • Expanded the description of the Technical Expert Panel, with discussion of:
    1. Factors that constitute a balanced TEP membership
    2. Times (suggested) when stakeholder input can be obtained during the measure lifecycle.
  • Expanded the description of Public Comment, again adding suggested times for this type of input during the measure lifecycle.

When in doubt about processes, measure developers should consult with their COR/GTL.