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

    CMS UPDATE: The NQF contract with the Centers for Medicare & Medicaid Services (CMS) for CQMC Program support ended on March 26, 2023. NQF is working with CMS and America’s Health Insurance Plans (AHIP) to transition the CMS-funded portions of CQMC work to the successor contractor, Battelle, over the coming months. NQF will continue a subset of CQMC work supported by AHIP and the CQMC membership. For CQMC inquiries, please contact both Erin O’Rourke at eorourke@ahip.org and Battelle at cqmc@battelle.org.

    The Core Quality Measures Collaborative (CQMC) is a broad-based coalition of healthcare leaders working to facilitate cross-payer measure alignment through the development of core sets of measures to assess the quality of healthcare in the United States. Founded in 2015, the CQMC is a public-private partnership between America’s Health Insurance Plans (AHIP) and the Centers for Medicare & Medicaid Services (CMS) housed at the National Quality Forum (NQF). The membership is comprised of over 70 member organizations health insurance providers, primary care and specialty societies, consumer and employer groups, and other quality collaboratives. CQMC is a membership driven and funded effort with additional funding provided by CMS and AHIP. The CQMC is currently convened by the National Quality Forum (NQF) in its role as the consensus-based entity.

    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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