CMS Finalizes its Measures Under Consideration List for Pre-rulemaking

Medicare and other payers are rapidly moving toward a health care system that rewards high quality care while spending taxpayer dollars more wisely. Foundational to the success of these efforts is having quality measures that are meaningful to patients and providers alike, and that drive improvement and better outcomes for patients. Each year, CMS publishes a list of quality and cost measures that are under consideration for Medicare quality and value-based purchasing programs, and collaborates with the National Quality Forum (NQF) to get critical input from multiple stakeholders, including patients, clinicians, commercial payers and purchasers, on the measures that are best suited for these programs. Ultimately, these measures may help patients and families choose the nursing home, hospital, or clinician that is best for them, and can help providers deliver the highest quality of care to their patients.

I am happy to announce that CMS posted the final Measures under Consideration List on the CMS website and has sent them to NQF in preparation for this multi-stakeholder input. They can be found on the CMS website, at https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures/Pre-Rule-Making.html and on the National Quality Forum’s (NQF) website, at http://www.qualityforum.org/Setting_Priorities/Partnership/Measure_Applications_Partnership.aspx).

This year’s MUC list contains 97 measures that have the potential to drive improvement in quality across numerous settings of care. CMS is considering new measures for nursing homes, hospitals, clinician practices, and dialysis facilities, among other settings, and continues to focus on important measures of patient outcomes, appropriate use of diagnostics and services, cost, and patient safety. This year, 39 percent of measures on the Measures under Consideration List are outcome measures, and an increased number of measures were submitted for consideration by specialty societies. CMS is committed to working with specialty societies and other stakeholders on the development and use of measures that are most meaningful to patients and clinicians for our programs.

The Affordable Care Act (ACA) (P.L. 111-148, enacted on March 23, 2010) added Section 1890A to the Social Security Act (the Act), which requires that the Secretary of the Department of Health and Human Services (HHS) establish a federal “pre-rulemaking process” for the selection of certain categories of quality and efficiency measures for use in various Medicare quality programs.  These measures and programs are described in section 1890(b)(7)(B) of the Act. One of the steps in this process requires that the Secretary make publicly available a list of quality and efficiency measures by December 1st that CMS is considering for adoption, through the annual rulemaking process, for use in these Medicare programs.  Additionally, this provision requires HHS to contract with a consensus-based entity (currently the National Quality Forum) to “convene multi-stakeholder groups to provide input on the selection of quality measures” for the programs specified in the law.   

Subsequent to the posting of the Measures under Consideration List, NQF will accept comments on the list and convene the multi-stakeholder from the public on behalf of and for consideration by the Measure Applications Partnership (MAP) to review and provide input on which measures are most suitable for Medicare’s quality and value-based purchasing programs. This is the sixth year that CMS has collaborated with NQF on this pre-rulemaking process, and together we have worked to make the process more efficient and the feedback more meaningful. The input that we receive from the MAP is invaluable, and reflects the viewpoints of many experts in the field of quality and value, most importantly patients and consumers.

We invite you to review the Measures under Consideration List in detail and to participate in the public process during the MAP review. We believe it is critically important to hear all voices in the selection of quality and efficiency measures that are used for accountability and transparency purposes and look forward to another successful pre-rulemaking season. We are committed to working with patients, clinicians and others on how to best measure the quality and value of care while reducing burden on providers and driving improved outcomes for patients at lower costs.

For more information regarding the MAP’s purpose, meetings, 2016 Measures under Consideration List deliberations and voting, visit the NQF website, at http://www.qualityforum.org/map/.

More Items in November 2016

• Nov 28, 2016
  What is the Quality Payment Program?
• Nov 28, 2016
  Two Day Hands on Dental Medical Billing Class. Escape Winter in Ft Lauderdale
• Nov 18, 2016 - By NAMAS - Shannon O. DeConda, CPC, CPC-I, CEMC, CMSCS, CPMA
  Preventive Medical Services
• Nov 15, 2016
  New Mapping Tool - CPT/HCPCS Medicare Denial Rates & Average Charges
• Nov 11, 2016
  New! Add codes to your code lists from the Search page
• Nov 09, 2016
  New Mapping Tools!
• Nov 07, 2016
  Find-A-Code Superbill Builder
• Nov 01, 2016
  Medicare's Services and Charge History! Check out our New Tool!

To view more items select a month from our "Items by Month" list.

Or view documentation, coding and billing articles.