In finalizing its initial core set of 26 healthcare quality measures for Medicaid-eligible adults, the Centers for Medicare & Medicaid Services borrows heavily from quality measures already required by the Electronic Health Record Incentive Program, as well as other performance measurement programs.
The core set of quality measures, required by section 2701 of the Affordable Care Act and published in the Federal Register Jan. 4, can be used by states to assess the quality of healthcare provided to adults eligible for the Medicaid program. "Identification of the initial core set of measures for Medicaid-eligible adults is an important first step in the overall strategy to encourage and enhance quality improvement," the CMS notice reads.
The 26 quality measures--whittled down from an original field of 51--align "to the degree possible" with existing federal reporting programs, according to the notice. Of the 26 measures, 17 already are required by existing quality measurement programs such as the EHR incentive program. More than one-third (nine in all) specifically are part of the Stage 1 Meaningful Use requirements, including breast cancer screening, Chlamydia testing and smoking cessation assessment.
Many of the other quality measurement programs align with guidelines from accrediting bodies such as the Joint Commission's Oryx performance measurement program or National Committee for Quality Assurance (NCQA) accreditation, as opposed to government programs.
Over the next year, CMS will phase in components of this quality measurement program to further identify measurement gap areas and begin testing the collection of measures. In the latter part of 2012, CMS will release technical specifications as a resource for states to collect and report the measures; by January 2013, CMS will issue guidance for states to submit the initial core set in a standardized format.