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CMS and Insurance Providers Issue New Quality Measures

The Centers for Medicare & Medicaid Services and America’s Health Insurance Plans recently released new clinical quality measures to streamline what healthcare providers have to report to insurers and keep patient care at the forefront of their work. CMS and AHIP are part of a Core Quality Measures Collaborative of healthcare system participants that released the measures. 

“These measures support multi-payer alignment, for the first time, on core measures primarily for physician quality programs,” according to a news release from CMS. “This release is the first from the collaborative, which plans to add more measure sets and update the current measure sets over time. CMS and the partner organizations believe that by reducing the complexity for providers and focusing quality improvement on key areas across payers, quality of care can be improved for patients more effectively and efficiently.” 

Currently, physicians and other clinicians must report multiple quality measures to different entities. Measure requirements are often not aligned among payers, which has resulted in confusion and complexity for reporting providers. “This agreement … will reduce unnecessary burden for physicians and accelerate the country’s movement to better quality,” said CMS Acting Administrator Andy Slavitt. The guiding principles used to create the core measures include that they be “meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost.” 

The goal is to establish broadly agreed upon core measure sets that could be harmonized across both commercial and government payers. Implementation of the measures will occur in several stages. CMS is already using measures from the each of the core sets but there will be a notice and public comment rulemaking process to implement new core measures in Medicare and remove those that are redundant and not part of the core group, according to the news release. 

The collaborative will continue to meet to monitor progress, encourage more participation, and add additional measures. “Members of the collaborative have taken a leadership role in identifying measures that will drive quality improvement and outcomes for patients,” said Carmella Bocchino, executive vice president, America’s Health Insurance Plans in the news release. “This is a first step of an ongoing process to ensure both public programs and the private sector align measures and reporting especially as we advance alternative payment models.” 

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