January 08, 2016

CMS Issues Quality Measure Development Plan

On Dec. 18, 2015, the Centers for Medicare and Medicaid Services (CMS) released the Quality Measure Development Plan (MDP): Supporting the Transition to the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs) to fill in gaps in quality measurements that will be used in both the MIPS and APM programs.

As mandated by Section 102 of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), CMS was required, with stakeholder input, to develop and publish a draft plan for the development of quality measures by January 1. It is soliciting for comments on the draft MDP until March 1.

The MDP serves as a strategic framework for clinician quality measure development to support MIPS and APMs for physicians and other eligible healthcare professionals. The measurement development plan builds on the existing set of clinician quality measures used in current CMS programs and prioritizes the development of outcome measures that are relevant to specialty providers. Through MACRA funding, CMS will expand and enhance existing measures to promote alignment and coordination across programs, settings, and payers while it develops new measures to fill performance gaps.

The MDP offers recommendations for filling gaps identified in quality measure sets used in Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VM) and Medicare Electronic Health Record (EHR) Incentive Program for Eligible Professionals (EPs), commonly known as Meaningful Use.

Future measure development outlined in the MDP will prioritize patient- and caregiver-centered experiences of care, patient-reported outcomes and patient health outcomes, communication and care coordination, and the appropriate use of resources across the following six quality domains:

  • Clinical Care
  • Safety
  • Care Coordination
  • Patient and Caregiver Experience
  • Population Health and Prevention
  • Efficiency and Cost Reduction

The MDP also describes how CMS will work collaboratively with federal and state partners and private payers to create an aligned set of measures that reduces provider burden. It covers tools, resources and activities that can contribute to the development of measures applicable to a wide variety of stakeholders.

In addition, the MDP addresses operational requirements specified by MACRA to include:

  • Multi-payer applicability
  • Coordination and sharing across measure developers
  • Clinical practice guidelines
  • Evidence base for non-endorsed measures
  • Quality domains and priorities
  • Gap analysis
  • Applicability of measures across health care settings
  • Clinical practice improvement activities, considerations for electronic specifications
  • Qualified clinical data registries (QCDRs)

MACRA mandates that the final MDP must be completed and posted on the CMS.gov website by May 1, 2016. Annual and appropriate interim updates will follow.

For questions, please contact Judy Burleson at jburleson@acr.org.