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National Impact Assessment of the Centers for Medicare & Medicaid Services (CMS) Quality Measures Reports

The National Impact Assessment of the Centers for Medicare & Medicaid Services (CMS) Quality Measures Reports (Impact Reports) are mandated by section 3014(b), as amended by section 10304, of the Patient Protection and Affordable Care Act (ACA), which provides that the Secretary shall, not later than March 1, 2012, and at least once every three years thereafter, conduct an assessment of the quality and efficiency impact of the use of endorsed measures described in section 1870(b)(7)(B) of the Social Security Act and make such assessment available to the public. The reports provide a quality check to determine if CMS is making progress on the healthcare delivery system to achieve the three aims of better care, smarter spending, and healthier people.

2015 Report

The 2015 Impact Report encompasses 25 CMS programs and nearly 700 quality measures from 2006 to 2013 and employs nine key research questions.  A Technical Expert Panel (TEP) of quality measurement leaders from across the healthcare industry and a Federal Assessment Steering Committee (FASC), consisting of stakeholders from CMS and other U.S. Department of Health and Human Services (HHS) agencies, were convened to provide input into the report.    

The key findings of the 2015 Impact Report indicate that CMS is making a difference for the patients we serve.  Highlights include:

  • CMS quality measures support the National Quality Strategy (NQS) and CMS Quality Strategy.  CMS quality measures reach a large majority of the top 20 high-impact Medicare conditions experienced by beneficiaries with improved coverage and balance of quality measures addressing the six measure domains related to the NQS priorities. 
  • Quality measures signal Improvement.  For example, approximately 35 percent of the 119 measures were classified as high performing, meaning performance rates exceeding 90 percent in each of the most recent three years for which data were available.  In addition, 95 percent of 119 publicly reported performance rates across seven quality reporting programs showed improvement during the study period (2006–2012).
  • CMS quality measures impact patients beyond the Medicare population.  Over 40 percent of the measures used in CMS quality reporting programs include individuals whose healthcare is supported by Medicaid, and over 30 percent include individuals whose healthcare is supported by other payer sources.
  • Provider performance on CMS measures related to heart and surgical care saved lives and averted infections.  From 2006 to 2012, 7,000 to 10,000 lives were saved through improved performance on inpatient hospital heart failure process measures, and 4,000 to 7,000 infections were averted through improved performance on inpatient hospital surgical process measures.

2012 Report

For the March 2012 report, CMS assessed the impact of quality measures within two categories:

  • Implemented measures with at least two years of performance information between 2006 and 2010.
  • Measures under consideration by CMS and made available to the public in December 2011.

The 2012 Impact Report can be accessed via the link in the Downloads section below.

Future Reports

CMS has 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 2018 Impact Report. HSAG has convened a TEP of nationally recognized experts in quality measurement and health policy to support this work.  Individuals representing patients and caregivers are included in the TEP to ensure the patient and caregiver perspectives are part of this assessment of the impact of the quality measures.  CMS has convened a FASC to participate in the planning and oversight of the Impact Assessment report and to advise the CMS Quality Measures and Health Assessment Group (QMHAG) on relevant policy and/or measurement issues. 

As new measurement programs are established, new clinical quality measures are added, and additional longitudinal data become available, a clear opportunity exists to quantify further the impact of these quality-reporting programs on patients and providers.  To that end, current projections for the 2018 Impact Report include all CMS quality reporting programs and nearly double the number of quality measures included in the 2015 Impact Report.  In addition to a more comprehensive database from which to conduct trend analyses, important focal points for the 2018 Impact Report include:

  • Quality measure impact on the CMS Quality Strategy goals
  • Impact of quality measurement on providers
  • Relationship between quality and cost

Useful Links

Working for Quality—The National Quality Strategy (NQS)