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Currently Accepting Comments


Public Comment Page: Currently Accepting Comments

This page serves as the designated site for CMS to solicit public comments on proposed quality measures.

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
  • Do not include personal health information in your comments. Your comments may be shared publicly.

List of Currently Accepting Comments:

Project Title: Development, Reevaluation, and Implementation of Outpatient Outcome/Efficiency Measures

Dates:

The call for public comment period opens on Monday, February 18, 2019 and closes on Monday, March 18, 2019.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) has contracted with Yale New Haven Health Services Corporation Center for Outcomes Research and Evaluation (CORE) and its partner, the Lewin Group (Lewin), to develop an electronic clinical quality measure (eCQM) that assesses the percentage of emergency department (ED) patients with a diagnosis of ST-segment elevation myocardial infarction (STEMI) who received appropriate treatment. The contract name is Development, Reevaluation, and Implementation of Outpatient Outcome/Efficiency Measures. The contract number is HHSM-500-2013-13018I. As part of its measure development process, CMS asks measure developers to hold a public comment period for measures under development to ensure its measures are created using a transparent process with balanced input from relevant stakeholders.

Project Objectives:

The project’s primary objectives, as they relate to this public comment, include:

Respecification of the OP-2 (Fibrinolytic Therapy Received within 30 Minutes of ED Arrival) measure concept, a chart-abstracted measure, to develop a de novo eCQM, including:

  • Providing feedback on electronic specification of the new measure, entitled Appropriate Treatment for STEMI Patients in the ED;
  • Making assessments on the measure’s importance, face validity, feasibility, and usability; and,
  • Recommending improvements as needed.

Documents and measures for comment:

These documents are provided for your review in comment. The files are found in the Download section:

STEMI eCQM measure specifications;

STEMI eCQM public comment framing document; and,

Instructions for commenting via JIRA.

Project Specific Instructions:

The STEMI eCQM is currently in a development stage; CMS is seeking feedback on the measure concept in advance of its finalization. All comments are welcome, but we are particularly interested in feedback in the following areas:

  1. The measure’s numerator includes STEMI patients whose time from ED arrival to fibrinolytic therapy is 30 minutes or fewer; non-transfer ED STEMI patients who received PCI at a PCI-capable hospital within 90 minutes of arrival; and, ED STEMI patients who were transferred to a PCI-capable hospital within 45 minutes of arrival at a non-PCI capable hospital’s ED.
    1. We seek feedback on determining a patient’s arrival time. Should arrival time be considered the time at which the patient arrives at the ED or the time at which he or she is placed in a room/bed within ED?
    2. We seek comments on delays in fibrinolytic therapy. What are appropriate reasons for delay in the administration of fibrinolytic therapy?
    3. We seek comments on non-administration of fibrinolytic therapy. What are acceptable reasons for not administering fibrinolytic therapy?
    4. We seek feedback on patient transfers. What is a reasonable time by which patients should be transferred for emergent STEMI care at another facility?
    5. We seek feedback on how to capture when patients receive PCI within 90 minutes of ED arrival.
  • As part of next steps in measure development, we plan to explore possible risk adjustment for expanding the measure population. There is a possibility that the measure population will remain small despite proposed changes due to epidemiological trends and regionalization of AMI care, particularly for patients seeking treatment for STEMI. Facilities that use fibrinolytics as a primary reperfusion strategy may have lower uptake of EHRs, use separate EHR systems, or maintain EHRs that do not meet standards for measurement of eCQMs.

f. We seek feedback on whether the certain EHR capabilities are necessary for the measure to be considered feasible.

    In addition to the questions above, we welcome your feedback on the following topics:

    • The usefulness of the STEMI eCQM to assess and improve the quality of care for STEMI patients;
    • The ability of the measure to assess facility performance
    • The potential for unintended consequences following implementation of the STEMI eCQM;
    • Whether data elements for the STEMI eCQM are available in structured, extractable fields in EHR systems; and,
    • Whether any additional exclusions should be added to the STEMI eCQM’s measure specifications.
    • Your answers to these questions will help inform measure development and strengthen the usefulness of the final measure to the field.

    How to Leave a Comment:

    To participate in public comment please visit the eCQM Tracker JIRA website hosted by the Office of the National Coordinator for Health Information Technology, at https://oncprojectracking.healthit.gov/support/projects/PCQM.

    For instructions on accessing JIRA and creating an account, please see the guidance included in the Downloads section below. All comments should be submitted on JIRA.

    The JIRA portal is a public forum into which protected health information (PHI) or personally identifiable information (PII) should not be entered. Please do NOT submit anything in your comments that would constitute PHI or PII (e.g., date of birth, Social Security number, health insurance claim number).

    If you are providing comments on behalf of an organization, include the organization’s name and contact information.

    If you are commenting as an individual, please submit identifying or contact information.

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    Project Title: Overall Hospital Quality Star Rating on Hospital Compare Public Input Request

    Dates:

    The Call for Public Comment period opens on February 28, 2019 and closes on March 29, 2019.

    Project Overview:

    The Centers for Medicare and Medicaid Services (CMS) contracted with Yale New Haven Health Services Corporation – Center for Outcomes Research and Evaluation (CORE) and Lantana Consulting Group, Inc. to develop and maintain the publicly reported Overall Hospital Quality Star Ratings. Here’s the contract information:

    • CORE contract:
      • Name: Development, Reevaluation, and Implementation of Outcome/Efficiency Measures for Hospital and Eligible Clinicians, Option Period 5
      • Contract number: HHSM-500-2013-13018I, Task Order HHSM-500-T0001
    • Lantana contract:
      • Name: MIDS III Hospital Compare Support Contract (HCSC)
      • Contract number: 75FCMC18D0029/75FCMC18F0001

    As part of its re-evaluation process, CORE and HCSC ask anyone interested to send comments about the refinement and maintenance of the Star Ratings methodology.

    Project Objectives:

    We’re asking for input from many stakeholders on several Overall Star Rating methodology updates now and to be considered in the future. Our goal with this public input period is to highlight technical and other considerations for the public.

    While we welcome public input on any aspect of the Overall Star Rating methodology, we’re specifically asking for comments about the potential methodological updates and topics in active re-evaluation.

    Documents and Measures for Comment:

    Here is the document for your review and comment:

    Overall Hospital Quality Star Rating on Hospital Compare Public Input Period

    This document has many methodological updates for public comment.

    Project Specific Instructions:

    If you’re sending comments for an organization, include the organization’s name and contact information.

    If you’re commenting as an individual, send your identifying or contact information.

    Please don’t include personal health information in your comments.

    Send your comments to cmsstarratings@yale.edu.

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    Downloads:

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