Projects

Development and Maintenance of Electronic Clinical Quality Measures (eCQMs)

2019-2024

Project Overview

Objective

The primary objectives of this project are to (1) develop and test new eCQMs for consideration and potential inclusion in the Merit-Based Incentive Payment System and (2) maintain about 50 eCQMs in the Merit-Based Incentive Payment System. 

Project Motivation

CMS needs valid, reliable, and feasible clinical quality measures to shift the basis of clinician reimbursement from the volume of care toward the value of care. Quality measures rely on data collected over the course of care delivery and payment. eCQMs draw information from EHRs, which contain a wealth of clinical data stored in structured, extractable fields. EHRs are superior to administrative claims for capturing patient symptoms, treatments, and test results, which help patients and payers understand the outcomes and quality of delivered health care.

Partners in Progress
  • National Committee for Quality Assurance
  • Physician Consortium for Performance Improvement
  • Telligen
  • Lantana Consulting Group
  • Amenity Consulting
 
Prepared For

U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services

U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Center for Clinical Standards and Quality

This project helps CMS’s Center for Clinical Standards and Quality develop, test, implement, and maintain electronic clinical quality measures (eCQMs) in CMS’s quality reporting and payment programs. eCQMs are quality measures that draw on information from electronic health records.
Since 2012, Mathematica has helped CMS’s Center for Clinical Standards and Quality develop, test, implement, and maintain eCQMs used in CMS quality reporting and payment programs. Mathematica and its partners work closely and collaboratively with a range of stakeholders, including patients, clinicians, electronic health record (EHR) vendors, and medical specialty societies to develop and test dozens of eCQMs, several of which have been endorsed or re-endorsed by the National Quality Forum. Mathematica incorporates human-centered design approaches, balanced with careful examination of the evidence and rigorous testing, to develop measures that are meaningful to patients and payers. As part of this project, the Mathematica team also maintains and annually updates about 50 eCQMs in the Merit-Based Incentive Payment System. Mathematica and its partners effectively implement new and evolving eCQM standards and actively seek review and feedback from implementers and vendors to continually improve the specifications.

Related Staff

Cindy  Cullen

Cindy Cullen

Director, Health Program Improvement

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Samuel Simon

Samuel Simon

Senior Researcher

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