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January 24, 2018

Will CMS' efforts to limit quality reporting to 'meaningful measures' pay off? Stakeholders aren't sure.

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    Industry stakeholders are expressing mixed opinions about CMS' latest effort to improve its quality measures, Maria Castellucci reports for Modern Healthcare, with some doubting the initiative will make much difference on the ground.

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    CMS each year releases an annual list of quality cost measures it will use in the upcoming year for Medicare quality and value-based purchasing programs.

    The list includes measures proposed by CMS and the public. CMS collaborates with the National Quality Forum (NQF) and receives input from stakeholders, including clinicians and commercial payers, on the measures.

    But stakeholders in the past have claimed that the industry tracks too many quality measures, many of which are low-value. Last year, for instance, the CMS list included roughly 100 measures.

    In response, CMS last fall unveiled the "Meaningful Measures" initiative, which CMS Administrator Seema Verma said would simplify quality measures, reduce regulatory burdens, and spur innovation.

    According to Modern Healthcare, this year's proposed list includes only 32 measures, focusing more on outcomes and including several patient-reported outcome measures.

    What stakeholders think

    While industry stakeholders generally support focusing on "meaningful" measures, they've questioned whether the initiative will truly reduce reporting burden, Modern Healthcare reports.

    Carolinas HealthCare System CMO James Hunter said the initiative "gave [Carolinas] reassurance that we are heading in the right direction and a framework for some of the work we had already been doing." But he also noted that Carolinas "may be further along in the maturation of working on these things," including with the measures in its quality improvement program for heart failure patients.

    Payers and providers also say the CMS effort aligns with industry trends to focus on measures of outcomes, rather than of process. Kedar Mate, chief innovation and education officer at the Institute for Healthcare Improvement, said, "The quality measurement movement is moving in the direction of outcomes-based measurement."

    But during a November webconference, some providers questioned whether CMS' efforts will reduce the reporting burden in practice.

    According to Modern Healthcare, the "Meaningful Measures" initiative focuses on measures related to broad aspects of care, such as "appropriate use" and "equity." But because those broad measures "include virtually everything," CMS hasn't actually "narrowed down anything," Robert Berenson, a health policy fellow at the Urban Institute, said.

    Ultimately, providers and payers agree that patient-reported outcome measures are the future of outcome measurement, Modern Healthcare reports. According to Mate, "What we want to do is measure the things that matter the most, and the only judge and jury of that are the patients we serve" (Castellucci, Modern Healthcare, 1/20).

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