2530 lines
88 KiB
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2530 lines
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<span>Get Started with Quality Measures</span>
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<span>Composite Measure</span>
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<span>Component Measures</span>
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</li>
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</ul>
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<a href="/about-quality/quality-at-CMS/goals">
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<span>CMS Goals and Priorities</span>
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</a>
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</li>
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<a href="/about-quality/quality-at-CMS/principles">
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<span>Measure Development Principles</span>
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</a>
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</li>
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<a href="/about-quality/quality-at-CMS/quality">
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<span>Quality Across CMS</span>
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</a>
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</li>
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</ul>
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</div>
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</div>
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<span>Blueprint Measure Lifecycle</span>
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<div class="desktop:grid-col-3">
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<div class="usa-nav__headermenu-item">
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<span><strong>Blueprint Measure Lifecycle</strong></span>
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<ul id="basic-nav-section-Blueprint-Measure-Lifecycle" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Blueprint-Measure-Lifecycle" >
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<a href="/blueprint-measure-lifecycle-overview">
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<span>Blueprint Measure Lifecycle Overview</span>
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</a>
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<a href="/about-quality/blueprint-measure-lifecycle/theory">
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<span>Measure Development Theory</span>
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</a>
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</li>
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</ul>
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</div>
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<span><strong>Measure Conceptualization</strong></span>
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<ul id="basic-nav-section-Measure-Conceptualization" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Conceptualization" >
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<a href="/measure-lifecycle/measure-conceptualization/overview">
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<span>Overview</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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<span>Information Gathering</span>
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<ul id="basic-nav-section-Information-Gathering" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Information-Gathering" >
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<a href="/measure-lifecycle/measure-conceptualization/information-gathering/overview">
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<span>Overview</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-conceptualization/information-gathering/conduct-environment-scan">
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<span>Conduct an Environmental Scan</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-conceptualization/information-gathering/analyze-data-gap-analysis">
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<span>Analyze Data & Conduct Gap Analysis</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-conceptualization/information-gathering/respecified-measures">
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<span>Respecified Measures</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-conceptualization/information-gathering/justify-creation-new-measures">
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<span>Justify the Creation of New Measures</span>
|
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</a>
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</li>
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</ul>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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<span>Business Case Development</span>
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</button>
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<ul id="basic-nav-section-Business-Case-Development" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Business-Case-Development" >
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-conceptualization/business-case/overview">
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<span>Overview</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-conceptualization/business-case/outcomes">
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<span>Documenting Outcomes, Benefits, & Costs</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-conceptualization/business-case/best-practices">
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<span>Business Case Best Practices</span>
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</a>
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</li>
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</ul>
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</li>
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</ul>
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</div>
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<div class="desktop:grid-col-3">
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<div class="usa-nav__headermenu-item">
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<span><strong>Measure Specification</strong></span>
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</div>
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<ul id="basic-nav-section-Measure-Specification" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Specification" >
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<a href="/measure-lifecycle/measure-specification/overview">
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<span>Overview</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-specification/specifications-measure-category">
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<span>Specifications by Measure Category</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-specification/define-data-sources">
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<span>Define Data Sources</span>
|
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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<button id="usa-accordion__button_second-3 usa-nav__submenu-list-2" class="usa-accordion__button_second usa-nav__link is_expanded closed" aria-expanded="false" aria-controls="basic-nav-section-Measure-Specification">
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<span>Develop Specifications</span>
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</button>
|
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<ul id="basic-nav-section-Develop-Specifications" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Develop-Specifications" >
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-specification/develop-specification/overview">
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<span>Overview</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-specification/develop-specification/target-initial-population">
|
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<span>Define the Target/Initial Population</span>
|
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</a>
|
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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<a href="/measure-lifecycle/measure-specification/develop-specification/denominator">
|
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<span>Define the Denominator</span>
|
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</a>
|
|
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|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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<a href="/measure-lifecycle/measure-specification/develop-specification/numerator">
|
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<span>Define the Numerator and Exclusions</span>
|
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</a>
|
|
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|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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<a href="/measure-lifecycle/measure-specification/develop-specification/stratification">
|
|
<span>Define Stratification Scheme</span>
|
|
</a>
|
|
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|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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|
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<a href="/measure-lifecycle/measure-specification/develop-specification/respecifying-registry-measures">
|
|
<span>Respecifying Registry Measures to Electronic Clinical Quality Measures (eCQMs)</span>
|
|
</a>
|
|
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|
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</li>
|
|
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|
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</ul>
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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<button id="usa-accordion__button_second-3 usa-nav__submenu-list-2" class="usa-accordion__button_second usa-nav__link is_expanded closed" aria-expanded="false" aria-controls="basic-nav-section-Measure-Specification">
|
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<span>Specify the Code</span>
|
|
</button>
|
|
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<ul id="basic-nav-section-Specify-the-Code" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Specify-the-Code" >
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-specification/specify-code/overview">
|
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<span>Overview</span>
|
|
</a>
|
|
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|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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|
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<a href="/measure-lifecycle/measure-specification/specify-code/code-systems-vocabularies-terminologies">
|
|
<span>Code Systems, Vocabularies, and Terminologies</span>
|
|
</a>
|
|
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|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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|
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<a href="/measure-lifecycle/measure-specification/specify-code/encode-clinical-information">
|
|
<span>Encoding Clinical Information</span>
|
|
</a>
|
|
|
|
|
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</li>
|
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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<a href="/measure-lifecycle/measure-specification/specify-code/data-standards">
|
|
<span>Data Standards</span>
|
|
</a>
|
|
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|
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</li>
|
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</ul>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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|
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<span>Construct Data Protocol</span>
|
|
</button>
|
|
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|
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|
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<ul id="basic-nav-section-Construct-Data-Protocol" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Construct-Data-Protocol" >
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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<a href="/measure-lifecycle/measure-specification/data-protocol/overview">
|
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<span>Overview</span>
|
|
</a>
|
|
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|
|
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</li>
|
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|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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|
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<a href="/measure-lifecycle/measure-specification/data-protocol/key-terms">
|
|
<span>Define Key Terms, Data Elements, Codes, and Code Systems</span>
|
|
</a>
|
|
|
|
|
|
</li>
|
|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
|
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|
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<a href="/measure-lifecycle/measure-specification/data-protocol/level-measurement-analysis">
|
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<span>Describe Level of Measurement & Sampling</span>
|
|
</a>
|
|
|
|
|
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</li>
|
|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
|
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|
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|
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<a href="/measure-lifecycle/measure-specification/data-protocol/risk-adjustment">
|
|
<span>Determine Risk Adjustment</span>
|
|
</a>
|
|
|
|
|
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</li>
|
|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
|
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|
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<a href="/measure-lifecycle/measure-specification/data-protocol/time-interval">
|
|
<span>Define Any Time Intervals</span>
|
|
</a>
|
|
|
|
|
|
</li>
|
|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
|
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|
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|
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<a href="/measure-lifecycle/measure-specification/data-protocol/scoring">
|
|
<span>Describe Scoring & Calculation Algorithm</span>
|
|
</a>
|
|
|
|
|
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</li>
|
|
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|
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</ul>
|
|
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</li>
|
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|
|
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
|
|
|
|
|
|
|
<a href="/measure-lifecycle/measure-specification/document-measure">
|
|
<span>Document the Measures</span>
|
|
</a>
|
|
|
|
|
|
</li>
|
|
|
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|
|
<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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<span>Measure Harmonization</span>
|
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</button>
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<ul id="basic-nav-section-Measure-Harmonization" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Harmonization" >
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<a href="/measure-lifecycle/measure-specification/measure-harmonization/overview">
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<span>Overview</span>
|
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</a>
|
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-specification/measure-harmonization/alignment">
|
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<span>Measure Harmonization and Alignment</span>
|
|
</a>
|
|
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|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-specification/measure-harmonization/when-to-consider">
|
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<span>When to Consider Measure Harmonization</span>
|
|
</a>
|
|
|
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</li>
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</ul>
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</li>
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</ul>
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</div>
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<div class="desktop:grid-col-3">
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<div class="usa-nav__headermenu-item">
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<span><strong>Measure Testing</strong></span>
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</div>
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<a href="/measure-lifecycle/measure-testing/overview">
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<span>Overview</span>
|
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</a>
|
|
|
|
|
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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<span>Measure Testing Process</span>
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<ul id="basic-nav-section-Measure-Testing-Process" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Testing-Process" >
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<a href="/measure-lifecycle/measure-testing/process/overview">
|
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<span>Overview</span>
|
|
</a>
|
|
|
|
|
|
</li>
|
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|
|
|
|
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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|
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<a href="/measure-lifecycle/measure-testing/process/develop-workplan">
|
|
<span>Develop The Testing Work Plan</span>
|
|
</a>
|
|
|
|
|
|
</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-testing/process/perform-sampl">
|
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<span>Perform Sampling</span>
|
|
</a>
|
|
|
|
|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-testing/process/implement-and-analyze">
|
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<span>Implement, Analyze, Refine & Retest</span>
|
|
</a>
|
|
|
|
|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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<a href="/measure-lifecycle/measure-testing/process/summary">
|
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<span>Measure Testing Summary</span>
|
|
</a>
|
|
|
|
|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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|
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<a href="/measure-lifecycle/measure-testing/process/testing-respecified-measures">
|
|
<span>Testing Respecified Measures</span>
|
|
</a>
|
|
|
|
|
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</li>
|
|
|
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|
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</ul>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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<span>Measure Evaluation Criteria</span>
|
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</button>
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<ul id="basic-nav-section-Measure-Evaluation-Criteria" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Evaluation-Criteria" >
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-testing/evaluation-criteria/overview">
|
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<span>Overview</span>
|
|
</a>
|
|
|
|
|
|
</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-testing/evaluation-criteria/importance">
|
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<span>Importance</span>
|
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</a>
|
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-testing/evaluation-criteria/scientific-acceptability">
|
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<span>Scientific Acceptability</span>
|
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</a>
|
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-testing/evaluation-criteria/feasibility">
|
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<span>Feasibility</span>
|
|
</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-testing/evaluation-criteria/usability">
|
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<span>Usability & Use</span>
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<div class="views-row"><div class="views-field views-field-field-parent-title"><h1 class="field-content"><span class="glossify-exclude">Measure <abbr tabindex="0" title="<p><span class="glossify-exclude">Specifications</span> are measure instructions addressing data elements, data sources, point of data collection, timing and frequency of data collection and reporting, specific instruments used (if appropriate), and implementation strategies.</p> " class="glossify-tooltip-tip" lang="en">Specification</abbr></span></h1></div></div>
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<div property="schema:text" class="field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>Most <abbr tabindex="0" title="<p>The Patient Protection and Affordable Care Act defined a <span class="glossify-exclude">quality measure</span> as “a standard for measuring the performance and improvement of population health or of health plans, providers of services, and other clinicians in the delivery of health care services.” (<a href="https://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf">Pub. L. 111-148, 931</a>)</p> " class="glossify-tooltip-tip" lang="en">quality measures</abbr> produce rates; however, there are other <abbr tabindex="0" title="<p><span class="glossify-exclude">Scoring</span> is the method(s) applied to data to generate results/score. Most quality measures produce rates; however, other <span class="glossify-exclude">scoring</span> methods include categorical value, CV, count, frequency distribution, non-weighted score/composite/scale, ratio, and weighted score/composite/scales.</p> " class="glossify-tooltip-tip" lang="en">scoring</abbr> methods such as categorical value, <abbr tabindex="0" title="<p>A <span class="glossify-exclude">continuous variable</span> is a measure score in which each individual value for the measure can fall anywhere along a continuous scale and can be aggregated using a variety of methods such as the calculation of a mean or median (e.g., mean number of minutes between presentation of chest pain to the time of administration of thrombolytics).</p> " class="glossify-tooltip-tip" lang="en">continuous variable</abbr> (CV), count, <abbr tabindex="0" title="<p>A <span class="glossify-exclude">ratio</span> is a score derived by dividing a count of one type of data by a count of another type of data (e.g., number of patients with central lines who develop infection divided by the number of central line days). The key to the definition of a <span class="glossify-exclude">ratio</span> is that the numerator is not in the denominator.</p> " class="glossify-tooltip-tip" lang="en">ratio</abbr>, and composite/scales. Measure information must include a description of the scoring type.</p><p>The measure developer should describe the type of scoring, accompanied by an explanation of how to interpret the <abbr tabindex="0" title="<p>The <span class="glossify-exclude">measure score</span> is the numeric result computed by applying the measure specifications and scoring algorithm. The computed <span class="glossify-exclude">measure score</span> represents an aggregation of all appropriate patient-level data (e.g., proportion of patients who died, average lab value attained) for the measured entity (e.g., hospital, health plan, home health agency, clinician). The measure specifications designate the measured entity and to whom the measure applies.</p> " class="glossify-tooltip-tip" lang="en">score</abbr>, such as</p><ul><li>Higher score indicates better quality; improvement noted as increase in rate</li><li>Lower score indicates better quality; improvement noted as decrease in median value</li><li>Score within a defined interval (or a “passing score” over or under a certain threshold) indicates better quality</li></ul><h3>Develop the Calculation Algorithm</h3><p>The measure <abbr tabindex="0" title="<p><span class="glossify-exclude">Logic</span> is the criteria used to define a quality measure and its key components.</p> " class="glossify-tooltip-tip" lang="en">logic</abbr> - sometimes referred to as the performance calculation, <span class="glossify-exclude">calculation algorithm</span>, measure score calculation diagram, or measure flow - is an ordered sequence of <abbr tabindex="0" title="<p>A data element is a basic unit of information with a unique meaning and subcategories (data items) of distinct value. National Institute of Standards and Technology. (n.d.). <em>Data element</em>. Computer Security Resource Center. Retrieved November 1, 2023, from&nbsp;<a href="https://csrc.nist.gov/glossary/term/data_element">https://csrc.nist.gov/glossary/term/data_element</a></p> " class="glossify-tooltip-tip" lang="en">data element</abbr> retrieval and aggregation through which the measure identifies the <abbr tabindex="0" title="<p>The <span class="glossify-exclude">numerator</span> is the upper portion of a fraction used to calculate a rate, proportion, or ratio. Also called the measure focus, it is the target process, condition, event, or outcome. <span class="glossify-exclude">Numerator</span> criteria are the processes or outcomes expected for each patient, procedure, or other unit of measurement defined in the denominator. A <span class="glossify-exclude">numerator</span> statement describes the action satisfying the conditions of the performance measure.</p> " class="glossify-tooltip-tip" lang="en">numerator</abbr> and <abbr tabindex="0" title="<p>The <span class="glossify-exclude">denominator</span> is a statement describing the population evaluated by the performance measure and is the lower part of a fraction used to calculate a rate, proportion, or ratio. It can be the same as the target/initial population or a subset of the target/initial population to further constrain the population for the purpose of the measure. CV measures may refer to this as measure population.</p> " class="glossify-tooltip-tip" lang="en">denominator</abbr> events or CV values. At the measure <abbr tabindex="0" title="<p><span class="glossify-exclude">Specifications</span> are measure instructions addressing data elements, data sources, point of data collection, timing and frequency of data collection and reporting, specific instruments used (if appropriate), and implementation strategies.</p> " class="glossify-tooltip-tip" lang="en">specification</abbr> stage, the <span class="glossify-exclude">calculation algorithm</span> is not necessarily an equation or a body of computer programming code, but instead is a depiction of the path from the raw data to the result. The measure developer must describe how to combine and use data collected to produce measure results. The <span class="glossify-exclude">calculation algorithm</span> can be a graphical representation (e.g., flowchart), text description, or combination of the two. <abbr tabindex="0" title="<p>The Medicare Improvements for Patients and Providers Act of 2008 requires the U.S. Department of Health and Human Services to contract with a consensus-based entity (CBE) regarding performance measurement. The CMS CBE endorses quality measures through a transparent, consensus-based process incorporating feedback from diverse groups of interested parties to foster health care quality improvement.</p> " class="glossify-tooltip-tip" lang="en">CMS consensus-based entity</abbr> requires submission of a measure score calculation diagram with the <a href="https://p4qm.org/SubmitaMeasure">Full Measure Submission form</a>. Revisions and updates continue to the <span class="glossify-exclude">calculation algorithm</span> through to the measure implementation stage where it is known as the implementation algorithm.</p><p>Development of the <span class="glossify-exclude">calculation algorithm</span> should be based on the written description of the measure. The measure description must contain enough information to develop the algorithm. The measure developer needs to check the <span class="glossify-exclude">calculation algorithm</span> for consistency with measure text, as the <span class="glossify-exclude">calculation algorithm</span> will serve as the basis for development of computer programming to produce measure results. The measure developer should account for each scenario and ensure there is a logical end point for each scenario. They should establish this through alpha testing and preliminary <abbr tabindex="0" title="<p><span class="glossify-exclude">Feasibility criteria</span> is the extent to which the specifications, including measure logic, require data that are readily available or easily captured without undue burden and implemented for performance measurement.</p> " class="glossify-tooltip-tip" lang="en">feasibility</abbr> assessments. These assessments will inform beta testing and also minimize implementation and reporting burden on the <abbr tabindex="0" title="<p><span class="glossify-exclude">Measured entities</span> are the front-line clinicians and their organizations, including health information technology, collecting quality measurement data. <span class="glossify-exclude">Measured entities</span> are the implementers of quality measures. The effect of quality measure data collection on clinician workflow can be negative. There may be effects on their payments, positive and negative, with respect to reporting and actual performance on quality measures. Because of these potential effects, <span class="glossify-exclude">measured entities</span> should be involved in all aspects of the Measure Lifecycle.</p> " class="glossify-tooltip-tip" lang="en">measured entity</abbr>. See <a href="/measure-lifecycle/measure-testing/overview" data-entity-type="node" data-entity-uuid="2752e5df-5e1b-44f1-a7a7-4ac490e0fab3" data-entity-substitution="canonical" title="Measure Testing">Measure Testing</a> for more information on responsibilities during this process.<br> </p></div>
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<div class="views-row"><span class="views-field views-field-changed"><strong class="views-label views-label-changed">Last Updated: </strong><span class="field-content"><time datetime="2024-12-03T12:24:14-05:00">Dec 2024</time>
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