processes, patient safety, efficient use of resources, health care costs, care coordination, patient and
consumer engagement, population and public health, and adherence to clinical guidelines. CMS’s
Meaningful Measures Initiative unites strategic efforts to reduce the burden of quality measure
reporting with a rigorous and comprehensive approach to identify and adopt measures that are the
most critical to providing high quality care and driving better patient outcomes at lower costs.
Specifically, CMS is actively working to encourage the use of parsimonious measure sets, develop more
timely feedback reports on performance based on data, and to further prioritize more all- payer,
patient-centric, population-based outcome measures, which allow a more targeted approach to
determining if this work leads to better outcomes at lower costs. As an initial step, with the support of
government contractors and federal stakeholders, CMS is prioritizing the development and use of
electronic clinical quality measures, improved electronic infrastructure, harmonized measures across
public and private quality reporting, and targeted efforts to address rural health concerns, health
inequities, population health, and patient reported outcomes in order to make better comparisons
across the healthcare ecosystem and over time.
CMS assesses the utility of specific measures for potential use in quality reporting programs and
selects measures that are meaningful to patients, actionable for providers with minimal burden of
implementation, and likely to improve health outcomes. All measures are evaluated using a Pre-
Rulemaking and Rulemaking multi-stakeholder review to solicit feedback. In addition, most all
measures used in CMS programs go through the process for National Quality Form (NQF)
endorsement, a rigorous and well established process to evaluate the impact, feasibility, validity, and
reliability of measures, including evaluation by the Scientific Methods Panel, a group of highly skilled
statisticians who are experts in measure evaluation. Measures to be used by CMS in programs also
must be evaluated by the Measure Application Partnership, a consensus based group of experts,
convened through the National Quality Forum, to evaluate and make recommendations to CMS on the
appropriateness of using measures in its programs. Finally, as noted earlier, all measures are
developed using technical expert panels who are skilled in their respective areas, to provide feedback
during development.
The impact of health and value of this program is the statutorily mandated submission of a triennial
Impact Assessment Report to Congress. CMS employs a comprehensive methodology to evaluate the
quality and efficiency impact of the use of endorsed measures in CMS reporting programs, including
patient impact and cost- avoided analyses, national surveys of quality leaders in hospitals and nursing
homes, and measure performance trends and disparity analyses. As defined in this report, Key
Indicators are measures or groups of measures used to gauge performance on aspects of six
Meaningful Measure priority domains: Patient Safety, Person and Family Engagement, Care
Coordination, Effective Treatment, Healthy Living, and Affordable Care. In the future, CMS is also
developing our analytics infrastructure to further evaluate the impact of each quality measure and
program.
Anticipated Challenges and Mitigation Strategies:
As part of CMS’s Meaningful Measures work, more focus is placed on new measure development from
Electronic Health Records (EHRs), such as electronic Clinical Quality Measures (eCQMs). CMS currently
uses many eCQMs in its various programs but the data are not publicly reported. When evaluating any
program or area, it will be important to be aware of these other measures since data may not be
publicly available for evaluation efforts at this time, but may be in the future.