Currently Accepting Nominations
This page serves as the designated site that is used to solicit nominations for technical expert panel members for CMS measure development and maintenance contractors. Individuals with expertise in the relevant fields including clinicians, statisticians, quality improvement, methodologists, and pertinent measure developers, as well as consumers, are encouraged to submit nominations. Person and family membership on TEPs is a very important part of the measure development process. TEP members are chosen to provide input to the measure contractor based on their personal experience and training. It is critical to the success that TEP members represent a diversity of perspectives and backgrounds.
TEPs Accepting Nominations:
- Development of Two Outpatient Outcome Measures for the Merit-based Incentive Payment System (MIPS)
- Impact Assessment of CMS Quality and Efficiency Measures
- MACRA Episode-Based Cost Measures - Call for Clinical Subcommittee
Project Title: Development of Two Outpatient Outcome Measures for the Merit-based Incentive Payment System (MIPS)
Update: The Clinician Committee nomination period has been extended and will now close on October 19, 2018.
The Centers for Medicare & Medicaid Services (CMS) has contracted with Yale New Haven Health Services Corporation – Center for Outcomes Research and Evaluation (CORE) to develop two outpatient outcome measures for the Merit-based Incentive Payment System. The two measures will assess the quality of care provided by clinicians who are eligible to participate in the MIPS (hereinafter, MIPS eligible clinicians).
- A measure focused on care provided for patients with heart failure (hereinafter, MIPS heart failure measure): The heart failure measure will assess admissions among a cohort of ambulatory patients with a diagnosis of heart failure.
- A measure focused on care provided for patients with diabetes (hereinafter, MIPS diabetes measure): The diabetes measure will assess hospitalizations and emergency department (ED) visits for hyperglycemia and hypoglycemia among a cohort of patients with diabetes.
Each measure will be risk-adjusted for patient complexity. The quality measure scores will be calculated using patient characteristics and outcomes documented on routinely submitted Medicare claims; therefore, the clinicians whose performance will be assessed by the quality measures will not need to submit any additional data directly to CMS.
In this posting, CORE is recruiting clinicians and professional society representatives to participate on Clinician Committees to inform the development of each of the measures. CORE will convene one Clinician Committee for the heart failure measure and another for the diabetes measure. We will ask Committee members to review materials and provide input to help shape the measures, such as which types of outcomes should be counted in the measures.
The contract name is Measure & Instrument Development and Support (MIDS): Development, Reevaluation, and Implementation of Outpatient Outcome/Efficiency Measures. The contract number for both the heart failure and diabetes measures is HHSM-500-2013-13018I.
We will convene two Clinician Committees of approximately 15 individuals each (15 for heart failure and 15 for diabetes). We will ensure that each Clinician Committee includes front-line clinicians from rural and/or underserved communities, professional/specialty society representatives, as well as other clinicians caring for patients with these conditions whose expertise reflects the qualifications below.
For the MIPS heart failure measure Clinician Committee:
Subject Matter Expertise: The heart failure measure will assess the quality of outpatient care for patients with heart failure. We are therefore seeking to engage professional society representatives, as well as primary care and specialty clinicians who provide ambulatory care to people with heart failure, or who are involved in the transition of these patients from hospital to home. These specialties include but are not limited to:
- Advanced heart failure specialists
- Primary care
- Internal medicine
- Palliative care
We are specifically seeking to include some front-line clinicians who treat patients with heart failure and who also:
- Practice in rural communities and/or underserved settings (e.g. federally qualified health centers), and/or
- Have expertise in performance measurement, quality improvement, care coordination, and/or health disparities.
For the MIPS short-term diabetes complications measure Clinician Committee:
Subject Matter Expertise: The short-term diabetes complications measure will assess the quality of outpatient care for patients with diabetes (both type 1 and type 2 diabetes). We are therefore seeking to engage professional society representatives, as well as primary care and specialty clinicians who provide ambulatory care to people with diabetes, or who are involved in the transition of these patients from hospital to home. These specialties include but are not limited to:
- Primary care
- Family medicine
- Internal medicine
We are specifically seeking to include some front-line clinicians who treat patients with diabetes and who also:
- Practice in rural communities and/or underserved settings (e.g. federally qualified health centers), and/or
- Have expertise in performance measurement, quality improvement, care coordination, and/or health disparities.
Participation on the Clinician Committees is voluntary. As such, individuals wishing to participate on one of the committees should understand that their input will be recorded in the meeting minutes. Proceedings of the Clinician Committees will be summarized in a report that is disclosed to the public.
All potential Clinician Committee members must disclose any current and past activities that may pose a potential conflict of interest for performing the tasks required of the committee. All potential members should be able to commit to the anticipated time frame needed to perform the functions of the Clinician Committees.
Expected Time Commitment:
CORE anticipates holding two to three teleconference meetings for each Clinician Committee between October 2018 and July 2019. Teleconference meetings will last approximately two hours. In addition, CORE anticipates holding all-day in-person meetings for each committee in the Baltimore/Washington D.C area in January or February 2019. There are limited per diem and travel funds available for clinicians representing underserved and/or rural communities.
If you wish to nominate yourself or other individuals for consideration, please complete the following and email it to MIPSoutcomemeasures@yale.edu.
- A completed and signed Nomination form located in the download section below.
- The nomination form includes a consent and confidentiality statement.
- A letter of interest (not to exceed 1 page) highlighting experience/knowledge relevant to the expertise described above and involvement in measure development.
- culum vitae or a summary of relevant experience for a maximum of 10 pages.
The TEP nomination period opens on September 27, 2018 and closes on November 2, 2018. Please submit all nomination materials by the closing date.
Section 1890A(a)(6) of the Social Security Act requires that the Secretary of Health and Human Services (HHS) conduct an assessment of the quality and efficiency impact of endorsed measures used in the Medicare programs, as described in section 1890(b)(7)(B) of the Social Security Act. The Centers for Medicare & Medicaid Services (CMS) has released a comprehensive report every three years, beginning with the first report in March 2012.
CMS contracted with Health Services Advisory Group, Inc. (HSAG) as part of the Measure & Instrument Development and Support (MIDS) Contract (contract number HHSM-500-2013-13007I; HHSM-500-T0002) to conduct the triennial assessment and report the findings to the public in the 2018 National Impact Assessment of CMS Quality Measures Report (2018 Impact Assessment Report). As required by its contract with CMS, HSAG is convening a technical expert panel (TEP) of stakeholders and experts to provide input on the development of the fourth triennial Impact Assessment Report, scheduled for release in 2021.
- Assess the quality and efficiency impacts of the use of measures in CMS reporting programs.
- Inform CMS, patients, providers, researchers, quality improvement entities, measure developers, and federal partners on progress toward achieving goals and objectives related to the CMS quality priorities expressed in the Meaningful Measures framework.1
- Inform policy on measure development, selection, implementation, removal, alignment, and gaps.
- Build infrastructure/methods to support CMS efforts to assess impact.
HSAG is seeking a TEP of approximately 15 to 20 individuals with the following perspectives and areas of expertise:
- Patient/family/caregiver perspectives
- Consumer and patient advocacy
- Social risk factors and disparities
- Health care quality improvement and clinical expertise in various settings (e.g., long-term care, acute care, ambulatory care, hospice)
- Quality measure development and evaluation, including statistical methods and survey design
- Health care economics and policy
Potential TEP members should understand that participation is voluntary and that their input will be recorded in the meeting minutes. Proceedings of the TEP will be summarized in a report that may be disclosed to the public. If a participant has chosen to disclose private, personal data, then related material and communications are not deemed to be covered by patient-provider confidentiality. Patient/caregiver participants may elect to keep their names confidential in public documents. HSAG will answer any questions about confidentiality.
All potential TEP members must disclose any current and past activities that may pose a potential conflict of interest for performing the tasks required of the TEP. All potential TEP members should be able to commit to the anticipated time frame needed to perform the functions of the TEP.
Patients and caregivers can provide essential input on health care quality based on their unique experiences. HSAG is seeking individuals who are thoughtful, engaged consumers of health care as patients (especially Medicare beneficiaries), family members, or other caregivers to participate on this TEP. Nominees will be expected to describe their experiences with health care to inform policy discussions about quality improvement and quality measures. Patient/caregiver nominees should submit a completed and signed TEP Nomination Form and a letter of interest as described below but are not required to submit a curriculum vitae.
TEP Expected Time Commitment:
During the term of service, members are expected to engage in the following activities:
- Participate in a two-day meeting in Baltimore, Maryland, anticipated to be approximately in late April or early May 2019.
- Review meeting materials in advance and complete a pre-assessment.
- Prepare to participate in the discussion and provide recommendations during the meeting.
- Provide periodic expert advice and feedback (via email or on a shared website), as needed.
The TEP Nomination Form and a proposed TEP Charter are found in the download section below. If you wish to nominate yourself or other individuals for consideration, please complete the form and email it to HSAG at ImpactAssessmentTEP@hsag.com with “Nomination” in the subject line. The nominee must submit the following documents by 11:59 p.m. ET on November 2, 2018.
- Completed TEP Nomination Form, including signed consent and confidentiality statements
- Applicant’s letter of interest (not to exceed two pages) highlighting experience and knowledge relevant to involvement in quality measurement and/or quality improvement and the expertise described above
- Curriculum vitae or summary of relevant experience (maximum of 10 pages). (Patient/caregiver participants are not required to submit a curriculum vitae and may elect to keep their names confidential in public documents.)
1. Meaningful Measures Hub: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityInitiativesGenInfo/MMF/General-info-Sub-Page.html
The nomination period for ten Clinical Subcommittees active during Wave 2 of measure development opened on February 6, 2018 and closed on March 20, 2018 at midnight ET. To be considered for the first in-person meeting, all nomination materials were to be submitted before the closing date. We will, however, continue to accept nominations on a continuous basis after this date; nominees who submit their information after this date will enter a standing pool of nominees who may be selected for participation in condition- or procedure-specific workgroups convened within each Subcommittee.
The Centers for Medicare & Medicaid Services (CMS) has contracted with Acumen, LLC to develop care episode and patient condition groups for use in cost measures to meet the requirements of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The contract name is “MACRA Episode Groups and Cost Measures.” The contract number is HHSM-500-2013-13002I, Task Order HHSM-500-T00002. As part of its measure development process, CMS asks contractors to convene groups of stakeholders and experts who contribute direction and thoughtful input to the measure developer during cost measure development and maintenance.
The project’s overall objective is to develop episode-based cost measures suitable for potential use in the Quality Payment Program. In Wave 2, Acumen has reconvened six of the original seven Clinical Subcommittees that participated in Wave 1 in 2017 (excluding Ophthalmologic Disease Management) as well as four new Subcommittees to contribute to the development of episode-based cost measures: Musculoskeletal Disease Management - Spine; Oncologic Disease Management - Medical, Radiation, and Surgical; Renal Disease Management; and Urologic Disease Management.
The process for Clinical Subcommittee (CS) member involvement in measure development has been updated for Wave 2 based on the feedback we received from Subcommittee members during Wave 1 on Subcommittee size and composition. Accordingly, all members who submit their nomination materials by the deadline and who are accepted will attend the first in-person meeting and will be added to the Clinical Subcommittee. Nominees who submit their information after this date will enter a standing pool of nominees who may be selected for participation in condition- or procedure-specific workgroups convened within each Subcommittee.
The Clinical Subcommittee is a large body of clinicians that will meet during an in-person meeting in Washington D.C. to: (i) select which episode-based cost measure to develop, and (ii) discuss the desired composition of the workgroup that will build out the selected measure.
The Subcommittee may reconvene in future waves of measure development to provide input for additional cost measures within the Subcommittee’s clinical area.
Once each Subcommittee selects which measure to develop, we will then create a smaller measure-specific workgroup within each Clinical Subcommittee.
The workgroups will include 5-10 members (with a maximum of 15) whose specialty, expertise, or experience is aligned with the scope of the selected episode-based cost measure and the workgroup composition criteria discussed by the standing Subcommittee during the first in-person meeting.
The workgroups will be formed after the Clinical Subcommittee’s in-person meeting from within the membership of the Clinical Subcommittee at large as well as the standing pool of nominees where necessary.
Workgroup members will be expected to attend an additional in-person meeting in June 2018 (exact dates to be determined).
For additional information about the project background or about the Wave 2 Clinical Subcommittee nomination period, please see the additional materials within the “MACRA Episode-Based Cost Measures-Call for Clinical Subcommittee” ZIP file available in the Downloads section at the bottom of this CMS webpage (direct link also available on the nomination form here).
List of Subcommittees Participating in Wave 2:
The list below presents the Subcommittees that we are recruiting for through this Call for Nominations. Below each Subcommittee, we list the procedural and acute inpatient medical condition episode groups in that Subcommittee’s clinical area that have been previously recommended for development by clinical stakeholders. However, this list is not limiting; the Subcommittee may recommend additional episode groups.
- Cardiovascular Disease Management Clinical Subcommittee - This Subcommittee may contribute to the development of one or more of the following episode groups: Acute Myocardial Infarction, Expired; Aortic Valve Procedure; Cardiac Arrhythmia & Conduction Disorders; Chest Pain; Coronary Artery Bypass Graft (CABG); Coronary Thrombectomy; Heart Failure & Shock; Implantable Cardiac Defibrillator (ICD) Implantation; Left Heart Catheterization; Mitral Valve Procedure; Pacemaker Implantation; Right Heart Catheterization; Supraventricular Tachycardia (SVT) Ablation; Syncope & Collapse; Thoracic Aortic Aneurysm Repair; Ventricular Tachycardia (VT) Ablation
- Gastrointestinal Disease Management - Medical and Surgical Clinical Subcommittee - This Subcommittee may contribute to the development of one or more of the following episode groups: Cirrhosis & Alcoholic Hepatitis; Diagnostic Colonoscopy; Disorders Of The Biliary Tract; Esophagitis, Gastroent & Misc Digest Disorders; G.I. Hemorrhage; G.I. Obstruction; Hernia Repair (Femoral Or Inguinal); Hernia Repair (Incisional Or Ventral); Hiatal Hernia Repair; Major Gastrointestinal Disorders & Peritoneal Infections
- Musculoskeletal Disease Management - Non-Spine Clinical Subcommittee - This Subcommittee may contribute to the development of one or more of the following episode groups: Ankle Fracture (No Dislocation); Bunionectomy; Femur Fracture Repair; Foot Fracture Or Dislocation; Fractures Of Hip & Pelvis; Hand Fracture Or Dislocation; Hip Arthroplasty; Humerus Fracture Repair; Knee Ligament Repair/Reconstruction; Meniscus Repair; Pelvic Fracture Repair/Treatment; Repair Of Arm Muscle Tendons (Not Including Rotator Cuff); Repair Of Foot Tendon/Ligament; Repair Of Hand Tendon/Ligament; Rotator Cuff Repair; Tibia Or Fibula Fracture Repair / Treatment; Toe Repair; Treatment of Hip Fracture/Dislocation; Treatment Of Shoulder Joint Or Clavicle Fracture/Dislocation; Wrist Fracture Treatment / Repair
- Musculoskeletal Disease Management - Spine Clinical Subcommittee - This Subcommittee may contribute to the development of one or more of the following episode groups: Axial Decompression (Including Laminectomy); Spinal Fusion; Treatment of Spinal Fracture or Deformity
- Neuropsychiatric Disease Management Clinical Subcommittee - This Subcommittee may contribute to the development of one or more of the following episode groups: Acute Ischemic Stroke W Use Of Thrombolytic Agent; Poisoning & Toxic Effects Of Drugs; Psychoses; Seizures; Transient Ischemia
- Oncologic Disease Management - Medical, Radiation, and Surgical Clinical Subcommittee - This Subcommittee may contribute to the development of one or more of the following episode groups: Melanoma Resection; Lumpectomy or Partial Mastectomy; Simple or Modified Radical Mastectomy; Subcutaneous Mastectomy; Colonic Resection; Pancreatic Resection Excluding Pancreatic Cancer; Rectal Resection; Surgical Procedure for Gall Bladder Disease
- Peripheral Vascular Disease Management Clinical Subcommittee - This Subcommittee may contribute to the development of one or more of the following episode groups: Abdominal Aortic Aneurysm Repair; Dialysis Access; Inferior Vena Cava Filter Placement; Procedure for Carotid Stenosis
- Pulmonary Disease Management Clinical Subcommittee - This Subcommittee may contribute to the development of one or more of the following episode groups: Allergic Reactions; Bronchitis & Asthma; Chronic Obstructive Pulmonary Disease; Pleural Effusion; Pulmonary Edema & Respiratory Failure; Pulmonary Embolism; Respiratory Infections & Inflammations; Respiratory System Diagnosis W Ventilator Support <96 Hours; Respiratory System Diagnosis W Ventilator Support >96 Hours; Septicemia Or Severe Sepsis W Mv >96 Hours
- Renal Disease Management Clinical Subcommittee - This Subcommittee may contribute to the development of one or more of the following episode groups: Endocrine Disorders; Kidney & Urinary Tract Infections; Other Kidney & Urinary Tract Diagnoses; Renal Failure
- Urologic Disease Management Clinical Subcommittee - This Subcommittee may contribute to the development of one or more of the following episode groups: Kidney Stone Removal or Destruction; Nephrectomy; Procedure for Benign Prostatic Hyperplasia; Prostate Cancer Treatment; Radical Cystectomy
All Subcommittee members who participated in Wave 1 in 2017 and are interested in continuing with Wave 2 of cost measure development must indicate their interest in an abbreviated nomination form shared directly with members via email. Existing members do not have to submit their nomination via the public nomination form. Please contact the Acumen measure development team if you did not receive an email.
Future Clinical Subcommittees
If you would like to be a part of a Clinical Subcommittee, but do not practice in any of the clinical areas we are recruiting for above, there will be future waves in which we convene additional Clinical Subcommittees. If you are interested in receiving updates regarding future Subcommittees, please provide your contact information on the MACRA Clinical Subcommittee Mailing List form.
List of Clinicians we are Recruiting:
Allergy/Immunology * Anesthesiology * Cardiac Electrophysiology * Cardiology * Certified Registered Nurse Anesthetist * Clinical Nurse Specialist * Clinical Psychologist * Colorectal Surgery * Critical Care (Intensivist) * Dentistry * Dermatology * Diagnostic Radiology * Emergency Medicine * Family Medicine * Gastroenterology * General Surgery * Geriatric Medicine * Hand Surgery * Hospitalists * Infectious Disease * Internal Medicine * Interventional Radiology * Interventional Cardiology * Licensed Clinical Social Worker * Mental/Behavioral Health * Nephrology * Neurology * Neurosurgical * Nurse Practitioner * Obstetrics/Gynecology * Occupational Therapy * Oncology * Orthopedic Surgery * Otolaryngology * Pathology * Pediatrics * Peripheral Vascular Disease * Physical Medicine and Rehabilitation * Physician Assistant * Plastic Surgery * Podiatry * Preventive Medicine * Psychologist * Psychiatrist * Pulmonary Disease * Radiation Oncology * Rheumatology * Speech Language Pathologist * Sports Medicine * Surgical Oncology * Thoracic Surgery * Urology * Vascular Surgery
Desired Qualifications of Clinical Subcommittee Members:
- Medical credentials relevant to the types of clinicians listed above
- Familiarity with medical coding (ICD-10, HCPCS/CPT, DRG)
- Board-certified or other professional certifications, as applicable
- Experience treating Medicare patients
Tasks and Expected Time Commitment for Clinical Subcommittee Members:
Tasks for All Clinical Subcommittee Members
2-4 hours to review Welcome Packet
1 in-person meeting lasting about 4 hours, for all CS members for episode group selection in downtown Washington, D.C. in April 2018 (exact dates for each Subcommittee can be found on the nomination form here after February 9) (plus travel time)
*Expected Time Commitment for Clinical Subcommittee Members who attend first in-person meeting = about 1.5 days total
Tasks for Workgroup Members Only
1 day-long in-person meeting for workgroup members only for episode group specification in downtown Washington, D.C. in May/June (exact dates to be determined) (plus travel time)
2-4 hours to prepare for Service Assignment and Risk Adjustment Webinar
2 hour Service Assignment and Risk Adjustment Webinar
2-4 hours to prepare for Refinement Webinar
2 hour Refinement Webinar
*Expected Time Commitment for Workgroup Members Only = about 3 days total
Nominees are required to submit a completed MACRA Clinical Subcommittee Nomination Form. As part of this form, nominees are required to upload (i) a letter of interest (not to exceed two pages) highlighting experience/knowledge relevant to the expertise described above and involvement in measure development, and (ii) a curriculum vitae or summary of relevant experience (not to exceed 10 pages). If you wish to nominate yourself or other individuals for consideration, please complete the form by March 20, 2018 at midnight ET to be considered for participation in Wave 2. Nominees who submit their information after this date will enter a standing pool of nominees who may be selected for participation in condition- or procedure-specific workgroups convened within each Subcommittee.
If you have any questions about the Clinical Subcommittees, the nomination process, or this project generally, please email email@example.com. If you would like to receive a 508-compliant PDF version of the nomination form for submission via email instead of the web-based form linked above, please email firstname.lastname@example.org to receive a blank form.
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