CQMC Revises Quality Measures, AHIP Advocates for Better Alignment

Core Quality Measures Collaborative (CQMC) released new core quality measures and the implementation guidelines for certain core sets.

More than 75 healthcare organizations, including payers, purchasers, and medical and consumer groups, shape and maintain the CQMC core measure sets. The sets are based on hundreds of quality measures. They cover 10 specialties.

Eight of the ten specialties experienced updates to their measures: accountable care organizations/patient-centered medical homes/primary care, behavioral health, cardiology, gastroenterology, HIV and hepatitis C, obstetrics and gynecology, orthopedics, and pediatrics.

The new measure additions include patient outcomes measures. Some of the measures also assess the quality of care coordination and care transitions.

CQMC also removed certain measures. Two criteria for removing quality measures were that the measures were no longer evidence-based or that the measures no longer significantly enhanced performance.

The changes will have direct implications for clinicians who seek to improve their quality of care. However, it also could affect CMS recommendations and measurements.

“CMS looks to input from organizations like the CQMC to inform its universal foundation and programs to advance aligned measurement that can improve the quality and equity of both health care and health of Americans,” said Michelle Schreiber, MD, deputy director of Center for Clinical Standards and Quality (CCSQ), and director of the Quality Measurement and Value-based Incentives Group (QMVIG) at CMS.

Leaders from CMS and AHIP stressed the value of alignment between federal, state, and private payers.

“Streamlined measurement can generate actionable information that empowers change for the better,” Danielle A. Lloyd, senior vice president of private market innovations and quality initiatives at AHIP and CQMC steering committee chair, said in the AHIP press release.

“That’s why the CQMC is focused on voluntary alignment by public and private payers around curated sets of rigorous measures as part of value-based care arrangements that reward coordinated care and improved patient outcomes.”

In 2022, the collaborative identified seven quality measure gaps that could be filled through digital and health equity quality measures. These gaps touched on outcome measurements, patient-reported outcome performance, cross-cutting specialties, health equity and care disparities, quality of care, levels of measurement, and finally, telehealth and virtual care.

CQMC was not the only quality measurement entity to discover gaps in 2022.

The National Committee for Quality Assurance (NCQA) changed its 2023 Healthcare Effectiveness Data and Information Set (HEDIS) quality measures in order to improve race and gender data collection and quality measures. The organization added race and ethnicity data stratifications and revisited women’s health and pediatric quality measures.

Like CQMC, NCQA has voiced its support for implementing digital quality measures, especially in the wake of the coronavirus pandemic.