Setting Priorities
Measure Applications Partnership
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Measure Applications Partnership 


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The Measure Applications Partnership (MAP) is a public-private partnership convened by The National Quality Forum (NQF), in partnership with the Centers for Medicare & Medicaid (CMS), to provide input to the U.S. Department of Health and Human Services (HHS) on the selection of performance measures for public reporting and performance-based payment programs.

The MAP’s pre-rulemaking work is conducted by the Coordinating Committee, the Clinician Workgroup, the Hospital Workgroup, the Post-Acute Care/Long-Term Care (PAC/LTC) Workgroup, the Rural Health Advisory group, and the Health Equity Advisory Group.

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What does MAP do?

Since 2011, CMS has called upon MAP to recommend consensus-based measures most appropriate for public reporting, performance-based payment, and other uses. One of MAP’s key initiatives is to convene multistakeholders for an intensive annual review of the quality measures being considered by CMS for almost 20 federal health programs. In convening MAP, the National Quality Forum (NQF) brings together representatives of Quality Measurement, Research, and Improvement, Purchasers, Providers, Public/Community Health Agency, Health Professionals, Health Plans, Consumers and Suppliers. MAP’s careful balance of these stakeholder interests ensures that the federal government will receive varied and thoughtful input on performance measure selection. As of this year, MAP involves approximately 150 healthcare leaders and experts representing nearly 90 private-sector organizations, as well as liaisons from three federal agencies.

More recently, NQF has convened a MAP Health Equity Advisory Group on behalf of the Centers for Medicare & Medicaid Services (CMS) to provide input on the measures under consideration (MUCs) with the goal of reducing health differences closely linked with social determinants of health (SDOH). The MAP Health Equity Advisory Group will participate in web meetings to review the MUC list and provide feedback to be included in the materials reviewed by the setting-specific Workgroups and the Coordinating Committee. Additionally, for the 2021-2022 MAP cycle, NQF will collaborate with CMS and the MAP Coordinating Committee to define a process for Measure Set Review (MSR). Initiated by CMS, the goal of this effort is to offer a holistic review of quality measures with input from diverse multistakeholders. This cycle will focus on developing a process for review and creating criteria for evaluating measures within federal programs.

MAP’s work fosters the use of a more uniform set of measures in federal programs and across the public and private sectors. This uniformity helps providers better identify key areas in which to improve quality; reduces wasteful data collection for hospitals, physicians, and nurses; and helps to inform patients and payers about the use of and need for quality measures.

MAP Successes

MAP has accomplished a variety of projects, ranging from guidance on measures for use in Medicare and Medicaid programs to more focused activities on strategic topics and specific populations, including:

  • Pre-rulemaking input – The Measure Applications Partnership (MAP) provides multistakeholder pre-rulemaking input to the Centers for Medicare & Medicaid Services (CMS) on measures under consideration for payment and reporting programs. During the 2020-21 cycle, MAP reviewed 20 measures under consideration, with one measure considered for two programs and one measure considered for eight programs. The measures reviewed included five process measures (including three COVID-19 vaccination measures), five cost/resource use measures, five outcome measures, three composite measures, and two patient reported outcomes performance measures (PRO-PMs).

  • Standardized Hospitalization Ratio for Dialysis Facilities (SHR) – Hospitalization rates vary across dialysis facilities, even after adjusting for patient characteristics. This suggests that hospitalizations might be influenced by dialysis facility practices. This NQF-endorsed measure seeks to improve patient outcomes by measuring hospitalization ratios among dialysis facilities. In addition, this measure seeks to promote communication between the dialysis facilities and other care settings to improve care transitions.

  • Hospital-Level, Risk-Standardized Patient-Reported Outcomes Following Elective Primary Total Hip and/or Total Knee Arthroplasty (THA/TKA) – This NQF-endorsed patient-reported outcome-based performance measure (PRO-PM) aligns with the goal of patient-centered approaches to health care quality improvement and targets high variability in hospital performance. The measure will estimate a hospital-level, risk-standardized improvement rate for PROs following elective primary THA/TKA for Medicare fee-for-service (FFS) patients 65 years of age or older. Substantial clinical benefit improvement will be measured by the change in score on the joint-specific patient-reported outcome measure (PROM) instruments, measuring hip or knee pain and functioning, from the preoperative assessment (data collected 90 to 0 days before surgery) to the postoperative assessment (data collected 270 to 365 days following surgery).

  • Colon and Rectal Resection Episode-Based Cost Measure – The Colon and Rectal Resection cost NQF-endorsed measure evaluates clinicians’ risk-adjusted cost to Medicare for patients who receive colon or rectal resections for either benign or malignant indications. The measure score is a clinician’s average risk-adjusted cost for the episode group across all attributed episodes. This inpatient procedural measure includes services that are clinically related and under the reasonable influence of the attributed clinician during the 15 days prior to the clinical event that opens or “triggers” the episode through 90 days after. Medicare beneficiaries enrolled in Medicare Parts A and B during the performance period are eligible for the measure. Person-Centered Primary Care Measure Patient Reported Outcome Performance Measure.

  • (PCPCM PRO-PM) – The Person-Centered Primary Care Measure Patient Reported Outcome Performance Measure (PCPCM PRO-PM) uses the PCPCM PROM (a comprehensive and parsimonious set of 11 patient-reported items) to assess the broad scope of primary care. Unlike other primary care measures, the PCPCM PRO-PM measures the high value aspects of primary care based on a patient’s relationship with the provider or practice. Patients identify the PCPCM PROM as meaningful and able to communicate the quality of their care to their clinicians and/or care team. The items within the PCPCM PROM are based on extensive stakeholder engagement and comprehensive reviews of the literature.

  • Global Malnutrition Composite Score – This NQF-endorsed Composite measure consisting of 4 component measures of optimal malnutrition care focuses on adults 65 years and older admitted to inpatient service who received care appropriate to their level of malnutrition risk and/or malnutrition diagnosis if identified. Appropriate care for inpatients includes to malnutrition risk screening, nutrition assessment for that at-risk, and proper malnutrition severity indicated along with a corresponding nutrition care plan that recommends treatment approach. The specifications for this measure have been updated since it was submitted to the MAP in 2018.

Learn more about MAP's work and access all of its published reports.

MAP's Structure and Membership

MAP’s overall strategy is set by the Coordinating Committee. MAP workgroups advise the Coordinating Committee on measures needed for specific care settings, care providers, and patient populations. Advisory groups provide input on specific topics, such as measurement issues affecting healthcare quality in rural populations, measurement issues impacting health disparities, and measurement issues impacting the over 1,000 United States critical access hospitals, to the Coordinating Committee and workgroups. The MAP Coordinating Committee provides final input to DHHS and CMS in reports and other deliverables.

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MAP’s processes are transparent. All MAP meetings are open to the public, and reports and other materials are made available on NQF’s website. Public comments are sought on MAP recommendations, and MAP reviews and considers every comment received.

Questions about MAP? Please contact MAPCoordinatingCommittee@qualityforum.org.