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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 11.1), 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 11.1

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 11.1, August 2015

Many changes in Version 11.1 were minor editorial clarifications and corrections. The more significant changes included:

  • Verified/Updated ICD-10 dates in Section 2 – Chapters 2 and 5
  • Updated priorities planning language
  • Included discussion of the ways that measurement affects or promotes payment reform
  • Increased references to family involvement
  • Modified best practices to encourage Patient and Caregiver participation in early stages of TEP
  • Defined stages of business case development, use of template to identify methods to determine incomplete template data in preliminary submissions.
  • More detailed information on how to produce an Environmental Scan
  • Added discussion on when additions or modifications to existing code sets may be required
  • Additional language on using OIDs as best practice for maintaining code set lists for any measure, not just eCQM measures
  • Updated and incorporated references to the Medicare Access and CHIP Reauthorization Act of 2015 and the most recent Quality Reporting Document Architecture (QRDA) releases.
  • Removed transitional terminologies
  • Updated calculations appendices to indicate that they do not only apply to eMeasures
  • Added Posting Expiration Duration to Web Posting Templates

Please see Appendix J: Blueprint v11.1 Change Document for an overview of all changes by chapters.

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