CMS Finalizes its Quality Measure Development Plan

May 6, 2016
Policy Snapshot

On May 2, the Centers for Medicare & Medicaid Services (CMS) posted the final Quality Measure Development Plan: Supporting the Transition to the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). CMS aims to drive improvement in our national health care system through the use of quality measures and periodic assessment of the impact of such measurement. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established payment incentives for physicians and other clinicians based on quality, rather than quantity, of care.

In December of 2015, CMS released their draft plan asking for comments. AMDA - The Society for Post-Acute and Long-Term Care Medicine submitted comments to the draft noting that “The Society strongly urges CMS to improve upon the current quality programs by ensuring that MIPS and APMs take into consideration the patient population in PALTC settings. Thus, we urge CMS to avoid adopting the one-size-fits-all approach as currently constructed under the Value-Based Modifier (VBM) and Meaningful Use (MU) programs, which have unfairly penalized and disincentivized physicians from seeing the most clinically complex and vulnerable patients.” The Society also suggested basic principles the plan should follow including providing an equitable payment system that incentives quality health care for a diverse patient population; align with patient goals of care; and reduce administrative burden.

The CMS finalized Quality Measure Development Plan includes:

  • Identification of known measurement and performance gaps and prioritization of approaches to close those gaps by developing, adopting, and refining quality measures, including measures in each of the six quality domains
    • Clinical care
    • Safety
    • Care coordination
    • Patient and caregiver experience
    • Population health and prevention
    • Affordable care
  • CMS actions to promote and improve alignment of measures, including the Core Quality Measures Collaborative, a work group convened by America’s Health Insurance Plans (AHIP). On February 16, 2016, CMS and the Collaborative announced the selection of seven core measure sets that will support multi-payer and cross-setting quality improvement and reporting across our nation’s health care systems.
  • Partnering with frontline clinicians and professional societies as a key consideration to reduce the administrative burden of quality measurement and ensure its relevance to clinical practices.
  • Partnering with patients and caregivers as a key consideration for having the voice of the patient, family, and/or caregiver incorporated throughout measure development.
  • Increased focus and coordination with federal agencies and other stakeholders to lessen duplication of effort and promote person-centered health care.