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Multi-Stakeholder Group Input on Quality Measures

Overview

CMS is issuing this List of Measures under Consideration to comply with Section 1890A of the Social Security Act (Act), which requires the Department of Health and Human Services (DHHS) to publicly present quality and efficiency measures it is considering for adoption through rulemaking for the Medicare program.   Because the list contains measures we are considering that were suggested to us by the public, this list is larger than what will ultimately be adopted by CMS for optional or mandatory reporting programs in Medicare.  When organizations, such as physician specialty societies, request that CMS consider measures, CMS attempts to include them and make these measures available to the public so that the Measure Applications Partnership (MAP), the multi-stakeholder groups convened as required under 1890A of the Act, can provide their input.

CMS will continue its goal of aligning measures across programs. Measure alignment includes establishing core measure sets for use across similar programs, and looking first to existing program measures for use in new programs.  Further, CMS programs must balance competing goals of establishing parsimonious sets of measures, while including sufficient measures to facilitate multi-specialty provider participation.  For example, the Physician Quality Reporting System (PQRS) program accounts for the bulk of the measures under consideration in this list, with the vast majority of these measures requested by physician specialty groups. 

Statutory Requirement

Section 3014 of the Patient Protection and Affordable Care Act of 2010 (ACA) created a new section 1890A Act, which requires the establishment of a federal pre-rulemaking process for the selection of quality and efficiency measures used by the Department of Health and Human Services (DHHS). Measures include those used under certain Medicare programs listed under section 1890(b)(7)(B)(i)(I) of the Act, as well as those used in reporting performance information to the public.  The pre­ rulemaking process includes:

  1. Making publicly available, by December 1st annually, a list of measures DHHS is considering for adoption through rulemaking for qualifying programs and for reporting performance information to the public;
  2. Providing the opportunity for multi-stakeholder groups to provide input by February 1st annually to DHHS on the selection of quality and efficiency measures and for DHHS to consider the multi-stakeholder groups’ input in selecting measures;
  3. Publishing the rationale for the use of any quality and efficiency measures that are not endorsed by the consensus based entity  under contract  with the DHHS under Section  1890 of the Act currently the National Quality Forum (NQF); and
  4. Assessing the quality and efficiency impact of the use of endorsed measures and making that assessment available to the public at least every three years (the first report was released in March 2012; please visit the webpage via the hyperlink in the Related Links section below).

Fulfilling Multi-Stakeholder Group Input Requirements

CMS submits the list of measures under consideration by December 1, 2012 to the NQF-convened Measure Applications Partnership (MAP) for its review and feedback. To view the CMS list of measures, the MAP review process and opportunities for the public participation in that process, and ultimately the final MAP feedback, please visit the NQF MAP webpage via the hyperlink in the Related Links section below.