Electronic Clinical Quality Measures Basics
Electronic clinical quality measures (eCQMs) are tools that help measure and track the quality of health care services that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) provide, as generated by a provider's electronic health record (EHR). Measuring and reporting eCQMs helps to ensure that our health care system is delivering effective, safe, efficient, patient-centered, equitable, and timely care. eCQMs measure many aspects of patient care, including:
- Patient and Family Engagement
- Patient Safety
- Care Coordination
- Population/Public Health
- Efficient Use of Healthcare Resources
- Clinical Process/Effectiveness
Health care providers are required to electronically report eCQMs, which use data from EHRs and/or health information technology systems to measure health care quality. To report eCQMs successfully, health care providers must adhere to the requirements identified by the CMS quality program in which they intend to participate.
Each year, CMS makes updates to the eCQMs approved for CMS programs to reflect changes in:
- Evidence-based Medicine
- Code Sets
- Measure Logic
To successfully participate in the Medicare and Medicaid Promoting Interoperability Programs, CMS requires EPs, eligible hospitals, CAHs, and dual-eligible hospitals to report on eCQMs. These eCQMs are determined by CMS and require the use of certified electronic health record technology (CEHRT).
For calendar year (CY) 2021, in order to be considered a meaningful user and avoid a downward payment adjustment, eligible hospitals and CAHs must use (1) existing 2015 Edition certification criteria, (2) the 2015 Edition Cures Update criteria, or (3) a combination of the two in order to meet the CEHRT definition, as finalized in the CY 2021 Physician Fee Schedule final rule (85 FR 84818 through 84828).
For more information about the 2015 Edition Cures Update, please review ONC's 21st Century Cures Act final rule. To check whether a health IT product has been certified to the 2015 Edition Cures Update criteria, visit the Certified Health IT Product List.
Medicare Promoting Interoperability Program eCQMs Requirements for 2021
2021 Electronic Reporting Requirements
- Reporting period is two self-selected quarters of CY 2021 data.
- Required to report on four self-selected eCQMs from the set of nine available.
- Submission period deadline: March 31, 2022.
Medicaid Promoting Interoperability Program Requirements for 2020
The 2020 eCQM reporting period for EPs is any continuous 90-day period within CY 2020. All participating EPs are required to report on any six eCQMs relevant to their scope of practice from the set of 47 available. In addition, EPs must report on at least one outcome measure. If no outcome measure is relevant to his or her scope of practice, the EP must report on one high priority measure. If no high priority measures are relevant to their scope of practice, they may report on any six relevant measures. The list of available eCQMs, including which qualify as outcome or high-priority can be found here (ZIP). More information on each eCQM can be found on the eCQI Resource Center.
Note: Under the Medicaid Promoting Interoperability Program, states have the flexibility to determine the method of reporting eCQMs and submission period, subject to prior approval by CMS. States also have the flexibility to determine the specifications that may be used to electronically report eCQMs under the Medicaid Promoting Interoperability Program.
eCQM Reporting Requirement Tables
- 2020 eCQM Reporting Requirements (PDF)
- 2021 eCQM Reporting Requirements (PDF)
- Eligible Professional eCQMs
- Eligible Hospital and Critical Access Hospital eCQMs