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Clinical Quality Measures

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The Centers for Medicare & Medicaid (CMS) defines Clinical quality measures, or CQMs as;

Tools that help us measure and track the quality of healthcare services provided by eligible professionals (EPs), eligible hospitals and critical access hospitals (CAHs) within 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. CQMs measure many aspects of patient care including: health outcomes, clinical processes, patient safety, efficient use of healthcare resources, care coordination, patient engagements, population and public health, and clinical guidelines.


CMS EHR Incentive Program

Stage 1

Reporting requirements for CQMs in Stage 1 are one of the 15 core objectives for Eligible Professionals (EPs) and one of the 14 core objectives for eligible hospitals. EP core objective #10 requires EPs report 3 core or alternative core and 3 additional measures totaling 6 measures. Hospital core objective #9 requires eligible hospitals report 15 measures.

EP Objective: Report ambulatory clinical quality measures to CMS.
Measure: Successfully report to CMS ambulatory clinical quality measures selected by CMS in the manner specified by CMS.
Exclusion: No exclusion.

Hospital Objective: Report ambulatory clinical quality measures to CMS.
Measure: Successfully report to CMS hospital clinical quality measures selected by CMS in the manner specified by CMS.
Exclusion: No exclusion.

Stage 2

In stage 2 CQM reporting is no longer under the classification of the objective but rather just a requirement for attestation. In stage 2 EPs must meet 17 core objectives and 3 of 6 menu objectives. Eligible hospitals must meet 16 core objectives and 3 of 6 menu objectives.

In 2014, all EPs and eligible hospitals will report CQMs using the new 2014 criteria no matter what stage (1 or 2) or program (Medicare or Medicaid) they are attesting. Reporting details are as follows:

  • EPs must report on 9 of the 64 approved CQMs
  • Recommended core CQMs – encouraged but not required
  • 9 CQMs for the adult population
  • 9 CQMs for the pediatric population
  • NQF 0018 strongly encouraged since controlling blood pressure is high priority goal in many national health initiatives, including the Million Hearts campaign
  • Selected CQMs must cover at least 3 of the National Quality Strategy domains
  • Eligible Hospitals and CAHs must report on 16 of the 29 approved CQMs
  • Selected CQMs must cover at least 3 of the National Quality Strategy domains
  • Beginning in 2014, all Medicare-eligible providers beyond their first year of demonstrating meaningful use must electronically report their CQM data to CMS. (Medicaid EPs and hospitals that are eligible only for the Medicaid EHR Incentive Program will electronically report their CQM data to their state.)

CMS Resources

Other Resources




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Last Updated: April 2, 2013