• AHIP, CMS, and NQF Partner to Promote Measure Alignment and Burden Reduction

    The Core Quality Measure Collaborative (CQMC) is a broad-based coalition of health care leaders convened by America’s Health Insurance Plans (AHIP) starting in 2015. The membership includes the Centers for Medicare & Medicaid Services (CMS), health insurance providers, medical associations, consumer groups, purchasers (including employer group representatives), and other quality collaboratives working together to recommend core sets of measures by clinical area to assess the quality of American health care.

    The U.S. healthcare system is moving from one that pays for the volume of services to one that pays for the value of services. Value-based payment requires quality, patient experience and efficiency metrics to assess the success of alternative payment models (APMs) and their participants at delivering value.

    The increased reliance on performance measures as part of these models led to a proliferation in the number of measures and a commensurate increase in burden on providers collecting the data, confusion among consumers and purchasers seeing conflicting measure results, and operational difficulties among payers. Thus, the CQMC aims to:

    • Identify high-value, high-impact, evidence-based measures that promote better patient outcomes, and provide useful information for improvement, decision-making and payment.
    • Align measures across public and private payers to achieve congruence in the measures being used for quality improvement, transparency, and payment purposes.
    • Reduce the burden of measurement by eliminating low-value metrics, redundancies, and inconsistencies in measure specifications and quality measure reporting requirements across payers.

    The CQMC seeks to continue its work through ongoing maintenance of the existing core measure sets to reflect the changing measurement landscape, including, but not limited to, changes in clinical practice guidelines, data sources, or risk adjustment. It further seeks to expand into new clinical areas not yet addressed. In addition, the CQMC seeks to identify gaps in measurement and challenges in implementation in order to advance adoption of the core sets.

    For more information, contact cqmc@qualityforum.org.

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