To address the challenges physicians and other clinicians encounter when having to report multiple quality measures to different payers, the Centers for Medicare and Medicaid Services (CMS) released seven sets of clinical quality measures intended to promote better alignment of measures for the practitioner community.
The Core Quality Measure Collaborative, which along with CMS includes America’s Health Insurance Plans (AHIP), the National Quality Forum, national physician organizations, employers and consumers, developed the core measure sets to standardize the quality measures that private and public payers use to gauge provider performance, thereby reducing the complexity, burden and costs associated with reporting requirements. The collaborative hopes the standardized metrics will lead to better outcomes in other areas as well, such as making it easier for consumers to use the reported data when making decisions about their health care, improvements in value-based payment and purchasing, and the promotion of evidence-based measurement that generates valuable information for quality improvement.
“In the U.S. health care system, where we are moving to measure and pay for quality, patients and care providers deserve a uniform approach to measure quality,” said Andy Slavitt, CMS’s acting administrator. “This agreement … will reduce unnecessary burden for physicians and accelerate the country's movement to better quality.”
Serving as a framework for future efforts to streamline quality reporting requirements, the initial core measure sets pertain to reporting by, or associated with, the following seven areas: accountable care organizations, patient centered medical homes and primary care; cardiology; gastroenterology; HIV and hepatitis C; medical oncology, obstetrics and gynecology; and orthopedics. Details about the specific measures in each set are available here.
CMS noted that it is already using some measures from each of the core sets. Those measures that are not already part of the agency’s metrics will be adopted “across applicable Medicare quality programs, as appropriate,” and measures that are not part of the core set will be eliminated. Commercial health plans will phase in the core measure sets as their contracts with providers are renewed.
The collaborative will monitor use of the measures for the purposes of modifying them as needed, minimizing unintended consequences and selecting new measures as better ones become available.
Dr. Stephen Ondra, senior vice president of Health Care Service Corp., which is part of the collaborative, said the core measure sets are “an important step in getting payers, providers, purchasers and consumers on the same page when they measure and compare health care quality. The efforts … will make health quality data more easily understood, less burdensome to collect and more relevant to the needs of all stakeholders. This work will ultimately help accelerate the shift toward payment models that are based on the value of care, rather than the volume.”
Our Take: We have heard the frustration from ACO management for years—one health system CEO told us that between their Medicare and commercial ACOs, they were tracking something like 300 quality measures. The reason why is that there were subtle, but different, measures to track in each contract.
This long-awaited announcement will go largely unnoticed, but trust us: physicians, payers, health systems and ACO executives breathed a collective sigh of relief after CMS released their statement on Tuesday.