HIV Measure Modernization: Developing Electronic Clinical Quality Measures for the HIV/AIDS Bureau

Mathematica developed three electronic clinical quality measures (eCQM) of HIV care. eCQM use data that are documented in electronic health records during the normal course of patient care. The three eCQM we developed include HIV Viral Suppression, HIV Annual Retention in Care, and Sexually Transmitted Infection (STI) Testing for People with HIV. We conducted an environmental scan, developed the measure specifications, and incorporated feedback from a technical expert panel and public comment period. We also shared draft specifications and requested feedback at the National Ryan White Conference on HIV Care & Treatment.  We then tested the feasibility, reliability, and validity of the measures using patient-level data from seven clinics that provide HIV care. The three eCQM were feasible to report using existing EHR data and had high reliability and validity. CMS proposed two of the eCQM (HIV Viral Suppression and STI Testing for People with HIV)  for inclusion in the MIPS program beginning in 2024, and the HIV Annual Retention in Care eCQM is under consideration for inclusion in future performance years. Inclusion in this CMS payment program will incentivize quality improvement for clinicians and ultimately drive improvements in care and outcomes for people with HIV.