CMS, AHIP Align and Simplify Quality Measures With 7 Core Sets

A collaboration led by CMS and America’s Health Insurance Plans (AHIP) has resulted in 7 sets of core quality measures created to support quality improvement and provide better alignment.

The measures were developed as part of a broad Core Quality Measures Collaborative of healthcare system participants in an effort to establish measures that will reduce complexity for reporting clinicians, decrease cost burden to consumers and the system, and ensure high-quality care for patients.

“In the U.S. health care system, where we are moving to measure and pay for quality, patients and care providers deserve a uniform approach to measure quality,” CMS Acting Administrator Andy Slavitt said in a statement. “This agreement today will reduce unnecessary burden for physicians and accelerate the country's movement to better quality.”

The core measures released are in the following 7 sets:

• Accountable care organizations, patient-centered medical homes, and primary care
• Cardiology
• Gastroenterology
• HIV and hepatitis C
• Oncology
• Obstetrics and gynecology
• Orthopedics.

The measures will be implemented in several stages. While CMS is already using measures from the core sets, it will implement new core measures while eliminating redundant measures. The Health Care Payment Learning and Action Network will integrate the measures as well. Finally, when contracts come up for renewal, commercial health plans will implement these core sets of measures.

Helen Burstin, MD, MPH, chief scientific officer of the National Quality Forum (NQF), which also participated in the Collaborative’s efforts, called the agreement on core measures sets “an important step” toward making healthcare more effective and efficient.

“Clinicians need fewer and more meaningful measures that reduce the burden of reporting multiple quality measures to different entities and take time away from direct patient care,” she said. “And consumers need measures that provide actionable information to better inform healthcare decisions.”

NQF provided technical assistance and many of the core measures are already endorsed by the organization.

The core measure sets will be reviewed on an ongoing basis and the Collaborative will develop a process to ensure the measure sets reflect the most up-to-date evidence.

“The Collaborative's efforts are a critical step forward in improving health outcomes and quality care for patients,” Carmella Bocchino, executive vice president of AHIP, said in a statement. “This process will ensure measures and reporting are consistent across programs in both the private and public sectors.”