The Centers for Medicare and Medicaid Services wants to get feedback on a list of 125 potential clinical quality measures for physicians and 49 potential measures for hospitals as part of its proposed rule for meaningful use stage 2. Ultimately, CMS will decide on just a subset of the suggested measures.
The agency plans to align clinical quality measures of various CMS quality reporting programs, such as the Physicians Quality Reporting System (PQRS) and Accountable Care Organizations.
CMS released its proposed rule for the meaningful use of electronic health records (EHRs) on Feb. 23. The agency will publish it in the Federal Register on March 7, and the public may comment for 60 days. The final rule is anticipated for late summer.
To line up clinical quality measures, CMS will need to choose the same measures for different program measure sets, standardize measure development and specifications methods across CMS programs and coordinate the efforts to involve stakeholders in quality measure and for public opinion.
[See also: CMS releases meaningful use proposed rule.]
It also means identifying ways to reduce multiple submission requirements and methods. For example, CMS said it is working towards allowing clinical quality measure data delivered through certified EHRs for meaningful use to apply to its other quality report programs.
“A longer term vision would be hospitals and clinicians reporting through a single, aligned mechanism for multiple CMS programs. We believe the alignment options for PQRS/EHR incentive programs proposed in this rule are the first step towards such a vision,” CMS said in the document. The agency is also exploring how intermediaries and state Medicaid agencies could participate in these efforts.
CMS will prioritize the clinical quality measures that encourage the use of outcome data on population health, those that improve patient safety, and those that calculate the progress in preventing and treating conditions that affect a large number of CMS beneficiaries and account for most of the program costs.
CMS will include the agreed upon set of clinical quality measures in the final stage 2 rule. The specifications and their updates will be posted on the EHR incentive program website.
Among the clinical quality measures that CMS is considering are:
• Percentage of patients with asthma who were evaluated at least once for asthma control
• Percentage of patients with hypertension and whose blood pressure was controlled during measurement year
• Percentage of patients with low back pain who did not have an imaging study (plain x-ray, MRI, CTscan) within 28 days of diagnosis
• Percentage of adult patients with diagnosis of acute bronchitis who were not dispensed an antibiotic prescription within 3 days of the initial date of service
• Percentage of patients adult patients with coronary artery disease seen within 12 months who were prescribed aspirin or clopidogrel, which inhibits blood clots
• Percentage of patients aged 65 years and older discharged from any inpatient facility and seen within 60 days of discharge in the office by their physician who reconciled discharge medications with current medication list in the medical record.