Electronic Clinical Quality Measures Basics
Electronic clinical quality measures (CQMs) 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 2015 Edition of certified electronic health record technology (CEHRT). For more information on 2015 Edition certified electronic health record technology (CEHRT), review this fact sheet (PDF).
Medicare Promoting Interoperability Program eCQMs Requirements for 2020
For first-time and returning participants, the 2020 reporting period for eligible hospitals and CAHs who report electronically is one self-selected quarter of calendar year (CY) data. The submission period will be the two months following the close of the each CY. If they submit electronically for 2020, they must submit four eCQMs from the list of eight available eCQMs.
- 2020 Electronic Reporting Requirements
- Required to report on four self-selected eCQMs from the set of eight available
- Submission period deadline: February 28, 2021
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