Updated Core Measures Focus on Improving Patient Care, Reducing Burden, and Eliminating Redundancies 

Washington, DC—Today, the Core Quality Measures Collaborative (CQMC) released four updated core measure sets covering specific clinical areas as part of its mission to provide useful quality metrics as the nation’s health care system moves from one that pays based on volume of services to one that pays for value. These updated core sets are a result of months of consensus-based review and deliberation among the group’s 75+ multi-stakeholder member organizations, evaluating hundreds of existing quality measures against the CQMC’s rigorous criteria. CQMC will release four additional updated core measure sets and two new core measure sets over the coming months.

“Today more than ever, we need to be supporting physician participation in value-based arrangements that provide a steady income, reward high-quality and efficient care, and reduce administrative burden to allow more time with patients,” said Elizabeth Goodman, JD, MSW, DrPH, Executive Vice President of Government Affairs and Innovation, America’s Health Insurance Plans (AHIP). “The release of today’s updated core measure sets is the direct result of collective work across the spectrum of CQMC’s member organizations to create useful tools in paying for value, reducing the data collection burden for health care providers and improving the quality of care for the patients they serve.”

The transition to a value-based payment system has seen an increased reliance on performance measures to assess the success of health care providers in delivering high-value, high-quality patient care within alternative payment models (APM). As APMs have grown in popularity, so too has the number of performance measures tied to these models. This explosion in performance measures has increased the data collection burden on providers and resulted in conflicting measure results that have confused both providers and consumers alike.

CQMC’s core measure sets address these challenges by promoting better patient outcomes, aligning measures across public and private payers, and reducing the burden of measurement by eliminating low-value metrics and redundancies. The CQMC has determined that the measures included in these sets are high-value, high-impact, and most appropriate for inclusion in APMs and other value-based contracting arrangements.

“CMS is prioritizing and aligning quality measurement across its programs to ensure high impact and parsimony,” said Lee Fleisher, MD, Chief Medical Officer, Centers for Medicare & Medicaid Services (CMS). “The CQMC core sets are a great vehicle to align measures not only across federal programs but with private payers.”

The four updated core measure sets released today cover:

• Gastroenterology
• HIV and Hepatitis C
• Obstetrics and Gynecology
• Pediatrics

In the coming months, the CQMC will release updated core sets in the following areas:

• Medical Oncology
• Orthopedics
• Primary Care/ Patient-Centered Medical Homes/ Accountable Care Organizations
• Cardiology

The CQMC will also release two new core sets that cover:

• Behavioral Health
• Neurology

“Data and accurate information are a critical lever for driving measurable health improvements together. We believe that joint efforts to integrate quality initiatives across public and private sectors through programs such as the Core Quality Measures Collaborative will alleviate burden for providers and patients alike,” said Shantanu Agrawal, MD, MPhil, president and CEO, National Quality Forum (NQF). “We have an opportunity to normalize high value care through the use of aligned measure sets that comprehensively drive improvement in key quality areas essential to value-based programs.”

The CQMC is a diverse coalition of health care leaders representing over 75 consumer groups, medical associations, health insurance providers, purchasers and other quality stakeholders, all working together to develop and recommend core sets of measures by clinical area to assess and improve the quality of health care in America. The coalition was convened in 2015 by America’s Health Insurance Providers (AHIP) and the Centers for Medicare & Medicaid Services (CMS) and is housed at the National Quality Forum (NQF).

Please click here for more information on the CQMC core measures. You can also view the CQMC Implementation Guide by clicking here. This guide provides strategies and actions for stakeholders seeking to implement or evolve value-based payment (VBP) programs.

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About National Quality Forum
The National Quality Forum (NQF) works with members of the healthcare community to drive measurable health improvements together. NQF is a not-for-profit, membership-based organization that gives all healthcare stakeholders a voice in advancing quality measures and improvement strategies that lead to better outcomes and greater value. Learn more at www.qualityforum.org.

About the Centers for Medicare & Medicaid Services
Established in 1965, the Centers for Medicare & Medicaid Services (CMS) is the largest insurance payer in the United States, covering more than 130 million Americans through programs such as Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). Using a collaborative and human centered design approach, CMS develops and maintains quality measurement programs, the oversight and standards certification program, and determines coverage analysis. CMS sponsors numerous quality improvement and innovation programs, such as the Center for Innovation (CMMI) and the Hospital Improvement and Innovation Networks (HIIN). CMS is leading the country in developing value-based health care to improve the lives of all patients. These programs help set health care standards used by many organizations across health care today. Visit www.cms.gov for more information.

About America’s Health Insurance Plans
America’s Health Insurance Plans (AHIP) is the national association whose members provide coverage for health care and related services to hundreds of millions of Americans every day. Through these offerings, we improve and protect the health and financial security of consumers, families, businesses, communities and the nation. We are committed to market-based solutions and public-private partnerships that improve affordability, value, access, and well-being for consumers. Visit www.ahip.org for more information.