Feds Release New Healthcare Quality Measures

Centers for Medicare and Medicaid Services proposes clinical reporting standards that physicians and hospitals will use to qualify for Stage 2 Meaningful Use bonus payments.

By Neil Versel, InformationWeek

A month after publishing proposed rules for Stage 2 of the Meaningful Use electronic health records (EHRs) incentive program, the Centers for Medicare and Medicaid Services (CMS) has finally posted complete sets of proposed clinical quality measures that hospitals and individual eligible providers will have to choose from to earn Medicare and Medicaid bonus payments starting in 2014.

With the new lists, CMS, which administers Meaningful Use, is attempting to align the quality measures in Meaningful Use and other programs designed to encourage providers to report how closely they follow recommended care protocols.

In the Stage 2 proposal, CMS said physicians and other providers must meet 12 clinical quality measures from a list of 125, including at least one measure from each of six domains: patient and family engagement; patient safety; care coordination; population and public health; effective use of healthcare resources; and clinical effectiveness. Hospitals, including federally designated critical access hospitals, must meet 24 of 49 measures, including at least one from each domain.

Hospitals may also submit quality measures through the Hospital Inpatient Quality Reporting System, and individual providers may do the same through the Physician Quality Reporting System (PQRS), so doctors and other eligible healthcare providers do not have to meet different standards to participate in both initiatives. “Submit once and get credit for both,” CMS insurance specialist Maria Michaels said at the 2012 Healthcare Information and Management Systems Society conference (HIMSS12) in late February.

The clinical quality measures together account for one of the “core” objectives that providers must meet in Stage 2. CMS is proposing that hospitals meet a total of 18 Meaningful Use measures–16 core objectives and two from a menu of four additional criteria–while eligible providers would have to comply with 17 core objectives and three of five menu items.

Federal officials unveiled the preliminary Stage 2 requirements at HIMSS12, though the proposed rule was not formally published until March. A 60-day comment period runs through May 7.

The agency indicated on its website that some of the measures are still under development and subject to change. Some have not received final endorsement from the National Quality Forum, a nonprofit organization under contract with the U.S. Department of Health and Human Services to develop benchmarks for improving the quality of healthcare.