Meaningful Measures specifics emerge: CMS program will track 18 areas

The aim of the core measures is to refocus the agency's regimen of quality metrics on high-quality healthcare and meaningful outcomes for patients, according to the agency.
By Mike Miliard
03:52 PM
Meaningful Measures

The Centers for Medicare and Medicaid Services on Tuesday offered further insight into how the Meaningful Measures program works. In a webinar, Jean Moody-Williams, RN, deputy director of CMS' Center for Clinical Standards and Quality, said the initiative to streamline quality reporting was launched in recognition that "there's a fine line between being helpful and being a hindrance."

CMS has heard the feedback from industry stakeholders that there are too many often-overlapping quality measures, and that it's often difficult to see how they relate to each other and how tracking and reporting them is meant to further common goals, said Moody-Williams.

"Tracking these measures does not always lead to better outcomes for patients," she said.

[Also: Meet 'Meaningful Measures,' the initiative CMS says will reduce regulatory burden]

And so, "as with all quality improvement efforts, it's time for a PDSA cycle to study or check what we've been doing before we keep doing it."

CMS has been working with payers, providers and vendors to develop the "most parsimonious and least burdensome measures set" possible, said Moody Williams, and would continue to fine-tune the new framework based on user feedback.

In the meantime, said Pierre Yong, MD, director of CMS' Division of Quality Measurement, it was time to refocus the agency's regimen of quality metrics on high-quality healthcare and meaningful outcomes for patients – to reduce the reporting burden on providers and concentrate on "why we went into healthcare to begin with."

Theodore Long, MD, senior medical officer at the Center for Clinical Standards and Quality, said there are two key problems CMS wants to solve with Meaningful Measures.

The first is to focus on the highest-priority measures for quality reporting and quality improvement. The second, he said, is to improve the agency's communications with patients, clinicians and stakeholders about what measures they should be paying most attention to.

Toward that end, he showed a diagram, with the patient at the center, surrounded by
overarching CMS goals: empower patients and doctors, improve CMS customer experience, allow for more state flexibility and support innovative approaches to improve quality, accessibility and affordability.

Extending out from that nucleus are six spokes, representing "cross-cutting principles or criteria – the important concepts we want every measure to be filtered through," said Long. Those are: reduce regulatory burden, improve access for rural communities, achieve cost savings, safeguard public health, track to measurable outcomes and impact and eliminate disparities.

Those principals, he said, represent the guiding framework for 18 different Meaningful Measure areas that CMS wants health systems to prioritize – they're further grouped under six thematic headings:

Make Care Safer by Reducing Harm Caused in the Delivery of Care

  • Healthcare-associated infections
  • Preventable healthcare harm

Strengthen Person and Family Engagement as Partners in their Care

  • Care is personalized and aligned with the patient's goals
  • End of life care according to preferences
  • Patient's experience and functional outcomes

Promote Effective Communication and Coordination of Care

  • Medication management
  • Hospital admissions and readmissions
  • Seamless transfer of health information

Promote Effective Prevention and Treatment of Chronic Disease

  • Preventive care
  • Management of chronic conditions
  • Prevention, treatment and management of mental health
  • Prevention and treatment of opioid and substance use disorders
  • Risk-adjusted mortality

Work with Communities to Promote Best Practices of Healthy Living

  • Equity of care
  • Community engagement

Make Care Affordable

  • Appropriate use of healthcare
  • Patient-focused episode of care
  • Risk-adjusted total cost of care

The next steps for CMS include gathering stakeholder feedback, working to address each component and assessing how to implement them and evaluating current measure sets and inform future development, said Yong.

But he clarified that the Meaningful Measures project does not supplant existing CMS quality improvement and payment programs, such as MIPS or CPC+.

"All of those will continue to exist," says Yong. "Meaningful Measures is a framework to help us think through, at a global level, what do we think are the most high-priority, high-yield measurement areas that would improve outcomes.

"It does not replace any of the existing quality reporting programs, nor is it intended to," he said. "This is meant as an overarching umbrella framework to help us coordinate our work and help people understand the right things to focus on."

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