Meaningful Measures 2.0

Meaningful Measures Initiative:

CMS continues to evolve Meaningful Measures 2.0 and the Cascade of Meaningful Measures framework to reflect the quality measurement priorities of the Agency.

When first introduced in 2017, the Meaningful Measures’ objective was to reduce the number of Medicare quality measures and ease the burden on measured entities. The Meaningful Measures initiative has helped CMS promote alignment across quality programs and reduce the number of Medicare quality measures by  42.5% from its launch in 2017 to 2026. This reduction in the number of quality measures coupled with a focus on a smaller set of high-impact measures contributes to cost savings and reduced administrative burden in the health care system.¹

The Meaningful Measures initiative made considerable progress, and its scope and purpose have evolved to keep pace with a rapidly changing healthcare environment. Meaningful Measures 2.0 promotes innovation and modernization of all aspects of quality, addressing a wide variety of settings, interested parties, and measurement requirements.

While the CMS National Quality Strategy provides an overarching, strategic plan that brings together initiatives and frameworks across the agency to ensure harmony and alignment across CMS quality efforts, it is Meaningful Measures 2.0 that serves as the key initiative for alignment of quality measurement. 

¹Saraswathula A, Merck SJ, Bai G, et al. The Volume and Cost of Quality Metric Reporting. JAMA. 2023;329(21):1840-1847.

Priorities & Measure Gaps

Meaningful Measures 2.0 addresses measurement gaps, reduces burden, and increases efficiency by:

• Using only high-value quality measures impacting key quality domains.
• Aligning measures across value-based programs and across partners, including CMS, federal, and private entities.
• Prioritizing outcome and patient-reported measures.
• Transforming measures to be fully digital and incorporating all-payer data.

Digital Quality Measurement

CMS prioritizes digital quality measures, which originate from health information captured and transmitted electronically via interoperable systems. CMS continues to improve our digital strategy by:

• Using Fast Healthcare Interoperability Resources (FHIR)-based standards to exchange clinical information through Application Programming Interfaces (APIs), allowing clinicians to digitally submit quality information one time which can be used in many ways;
• Accelerating the transition to fully electronic measures;
• Working across CMS to use artificial intelligence to identify quality problems and intervene before harm comes to patients;
• Developing more APIs for quality measure data submission and interoperability; and
• Harmonizing measures across registries.

Person-Centered Care

Meaningful Measures 2.0 promotes better collection and integration of individuals voices across CMS programs by:

• Simplifying how to use person-reported outcome performance measures (PRO-PMs) and integrating them into the electronic health record workflow.
• Developing PRO-PMs and embedding them into the workflow, allowing access through an API or patient portal, improving ease of use, and reducing reporting burden.
• Using National Institutes of Health-developed Patient-Reported Outcomes Measurement Information System® (PROMIS®) tools; and
• Working across CMS to use “Self-Reported Health” as an agency-wide key result that reflects the patient’s voice around quality of care.

Cascade of Meaningful Measures

The Cascade of Meaningful Measures is a framework to help prioritize existing health care quality measures, align or reduce measures where there are too many, and identify gaps where new measures may need to be developed. The framework starts by utilizing the eight health care priorities of Meaningful Measures 2.0. The Cascade of Meaningful Measures describes, in increased detail components of the health care system that are being measured. It moves from the eight Meaningful Measures health care priorities to topics and focus areas. For more information, check out the Cascade of Meaningful Measures website.

Next Steps

Meaningful Measures 2.0 will continue evolving with your help. Email your comments to meaningfulmeasuresqa@cms.hhs.gov.

Not sure where to start? Consider these questions:

• Are there gaps in the updated Meaningful Measures Initiative?
• Are there barriers or challenges to implementing the proposed changes and goals?