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HHS Quality Measures

In addition to non-profit Joint Commission hospital measures, a number of different clinical quality measures apply to healthcare organizations and clinicians, including the three federal programs listed below:

  • The Medicare and Medicaid EHR Meaningful Use Incentive Program (EHR-MU) provides incentive payments to eligible professionals and eligible hospitals for the “meaningful use” of certified electronic health record (EHR) technology to enhance quality, safety, and effectiveness of care.
  • The Physician Quality Reporting System (PQRS) provides incentive payments to eligible professionals who satisfactorily report data on quality measures (selected from among 240 measures) for covered services furnished to Medicare beneficiaries.
  • The E-Prescribing Incentive Program (ERx).

Altogether there are 366 quality measures across 23 CMS programs. To learn more about these, click here. The National Quality Forum (NQF) is working on evaluating these measures and will recommend measures by February 1st of each year to the US Deptmartment of Health and Human Services (D/HHS), as required by health care reform legislation (ACA).  An important goal undertaken by NQF is to align measures and eliminate inconsistencies and overlap. NQF convened a Measures Applications Partnership (MAP) to pioneer a new approach to input on measure selection for federal programs. On December 2, 2011 NQF received and posted to its website the list below of 366 quality measures under consideration by HHS for the 2012 rulemaking process.  For more information, visit the NQF website

Selection of Quality Measures for Federal (CMS) Programs. The Affordable Care Act requires the establishment of a federal “pre-rulemaking process” for the selection of quality and efficiency measures for specific qualifying programs within the Department of Health and Human Services (HHS). The process includes:

  1. Making publicly available, by December 1st annually, a list of measures currently under consideration by HHS for qualifying programs within the Department, including measures suggested by the public;
  2. Providing the opportunity for multi-stakeholder groups to review and provide input by February 1st annually to HHS on the measures under consideration, and for HHS to consider this input;
  3. Publishing the rationale for the selection of any quality and efficiency measures that are not endorsed by the National Quality Forum (NQF); and
  4. Assessing the impact of endorsed quality and efficiency measures at least every three years (the first report due to the public by March 1, 2012).

CMS is working to streamline the 366 quality measures. CMS is issuing this list in fulfillment of a statutory requirement to publicly present measures it is considering for adoption in the following year, including measures suggested by the public. Accordingly, it is a much larger list than will ultimately be adopted for optional or mandatory reporting programs in Medicare, Medicaid, and the Children’s Health Insurance Program. CMS will continue its goal of aligning measures across programs, including establishing “core” measure sets, while balancing competing goals of establishing parsimonious sets of measures, while including measures added at the request of physician specialty groups.

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