Fewer quality measures considered by CMS in 2018 pre-rulemaking list

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The annual list of measures being considered by CMS for inclusion in Medicare quality reporting and value-based programs is less than a third of the length of the previous list, reflecting the agency’s new commitment to reduce what physicians see as burdensome reporting standards.

The Measures Under Consideration (MUC) list released in Dec. 2016 included 97 measures. This year, it contains only 32, whittled down from 184 measures which had been submitted by stakeholders. A blog post from CMS chief medical officer and quality director Kate Goodrich, MD, MHS, said this is in line with the “Meaningful Measures” initiative recently announced by CMS Administrator Seema Verma.

“CMS is taking a new approach to coordinated implementation of meaningful quality measures focused on the most critical, highly impactful areas for improvement while reducing the burden of quality reporting on all providers so they can spend more time with their patients,” Goodrich wrote. “In addition to other factors, CMS evaluated the measures on the MUC list to ensure that measures considered for adoption in a CMS program through rulemaking as necessary, focus on clearly defined, meaningful measure priority areas that safeguard public health and improve patient outcomes.”

A key talking point of the new initiative was moving away from process-driven measures to ones based on outcomes. The 2016 and 2017 MUC lists, however, have a nearly equal share of outcomes measures, which made up 39 percent of last year’s list and 40 percent of the current list.

The new list also includes eight episode-based cost measures “that were developed by incorporating the insight and expertise of clinicians and specialty societies."

Broken down by program, 22 of the suggested measures would be included in the Merit-based Incentive Payment System (MIPS) established by the Medicare Access and CHIP Reauthorization Act (MACRA). The Medicare Shared Savings Program, End-Stage Renal Disease Quality Incentive Program and Hospital Inpatient Quality Reporting Program each have three measures on the list, the EHR Incentive Program has two and one measure may be added to quality reporting for ambulatory surgical centers, hospital outpatient services, skilled nursing facilities and cancer hospitals exempt from the Medicare Prospective Payment System.

As required by the Affordable Care Act, the measures will be reviewed by the National Quality Forum, which will allow for comment from stakeholders through Dec. 7. The full MUC list can be found here.