By Dr. Patrick Conway, Chief Medical Officer, Director of the Center for Clinical Standards and Quality
Quality improvement is a priority for CMS and one of the goals of the Medicare and Medicaid EHR Incentive Programs. The meaningful use of health information technology (health IT) can improve quality measurement, data collection, and reporting. At CMS, we believe that, by improving quality measurement, we will improve health care quality and outcomes.
In order to be successful, the implementation of quality measurement needs to be easy for providers in their routine practice to capture as part of the clinical workflow. With the implementation of the Medicare and Medicaid EHR Incentive Programs, CMS has taken steps to minimize the burden of data collection for providers.
Reducing the Burden of Data Collection Currently, eligible professionals must submit clinical quality measures (CQMs) under CMS programs to obtain payment incentives, fulfill public reporting requirements, or avoid payment penalties. Some eligible professionals participate in as many as three CMS quality programs:
1. Physician Quality Reporting System (PQRS) for Medicare 2. Physician Value-Based Payment Modifier for Medicare 3. Medicare and Medicaid EHR Incentive Programs
CMS has aligned some of the reporting requirements for these programs starting in 2014 to reduce the burden of data collection. Individual eligible professionals and group practices will be able to report once on a single set of clinical quality measures and satisfy some of the various requirements of all three programs.
Improving Quality Measurement Although there are currently many endorsed quality measures, there are few measures in areas like care coordination and patient engagement. The goal is to identify important measures, discontinue using those of little value, and construct measures into a portfolio that meet the needs of payers, policymakers, and the public.
Measurement Improvement Roadmap CMS, with the Department of Health and Human Services and the National Quality Forum, has developed a roadmap to improve meaningful quality measurements, and align the private and public health care sectors. Our strategies to improve the future of quality measurement will:
• Reduce the number of complex clinical data requirements and/or consider how data elements for a given measure will be captured as part of routine clinical workflow early in the measure development process,
• Establish automated systems to collect patient-reported outcomes and experiences that reach patients where they are (e.g., mobile, text), and
• Increase interoperability and the ability to move data throughout the health care system securely.
Advancing through eHealth We know that quality measurement is critical for advancing the nation’s health care system. The CMS eHealth initiative, through programs like the PQRS and the Medicare and Medicaid EHR Incentive Programs, will continue to find ways to implement quality measurement programs that reduces the burden of data collection for providers in order to achieve the ultimate goal of improving health care quality and outcomes.
For More Information For more information on quality measures and CMS’ roadmap for improvement, visit www.cms.gov/qualitymeasures.