Clinical Quality Measures (CQMs)

Clinical quality measures, or CQMs, are tools that help us measure and track the quality of healthcare services provided by physicians, nurses, hospitals and others in our health care system.  These measures use a wide variety of data that are associated with a provider’s ability to deliver high-quality care or relate to long term goals for health care quality.  Many factors are included in CQMs such as health outcomes, processes and systems in place at a facility, patient perceptions, and treatments provided.  

Continuously measuring and reporting these CQMs helps to ensure that our health care system can deliver effective, safe, efficient, patient-centered, equitable, and timely care.

CQMs are required as part of meaningful use requirements  for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. Health care providers who wish to participate in the program must measure and submit data from the EHR technology for a set of related CQMs in order to receive an incentive payment in the EHR Incentive Program.
 

There are 44 measures for eligible professionals to choose from based on program requirements and 15 for eligible hospitals and critical access hospitals under the current electronic specifications.  In addition, the proposed CQMs are available for review; however, the 2014 measures are subject to change under the Stage 2 Final Rule.   

Information on the EHR Incentive Program Electronic Reporting Pilot
EPs, eligible hospitals and CAHs are required to submit CQM results as calculated by certified EHR technology.  In 2012, there will be two options for CQM reporting:

• Attestation
• Electronic Reporting Pilots
  • EPs – through PQRS
  • Eligible hospitals and CAHs – through Hospital IQR Program  

Participation in the pilot is voluntary and enables EPs, eligible hospitals, and CAHs to satisfy the Medicare EHR Incentive Program requirements for reporting CQMs for the 2012 payment year. EPs, eligible hospitals, and CAHs that choose not to participate in the pilot will be able to continue to use an attestation methodology for reporting CQMs for payment year 2012.

For detailed information on the EHR Incentive Program Electronic Reporting Pilot, see the Electronic Specifications page of the CMS website.