CMS proposes universal quality measures across all programs

CMS is looking to create a "universal foundation" of quality measures across all its programs, such as Medicare and Medicaid.

The agency said in its 2024 advance notice Feb. 1 that aligning measures across programs and private payers "will reduce provider burden while also improving the effectiveness of quality." CMS operates more than 20 programs, each with its own set of quality measures that may or may not align with one another.

"The universal foundation is part of CMS's efforts to implement the vision outlined in our National Quality Strategy and is fundamental to achieving several of the agency's quality and value-based care goals," six CMS leaders wrote in The New England Journal of Medicine Feb. 1.

The universal foundation will function as a base for which programs can add additional aligned or program- and population-specific measures over time.

Preliminary foundation measure categories for adults: wellness and prevention, chronic conditions, behavioral health, seamless care coordination, person-centered care and equity.

Preliminary foundation measure categories for children: wellness and prevention, chronic conditions, behavioral health and person-centered care.

The agency leaders said that many of the measures chosen represent diseases and conditions associated with the highest morbidity and mortality rates.

"Our intention is that the universal foundation will eventually include selected measures for assessing quality along a person’s care journey — from infancy to adulthood — and for important care events, such as pregnancy and end-of-life care," they wrote.

CMS did not provide a timeline for launching the universal measures but said it will collect feedback on the proposal through various mediums, and work with states on any reforms to Medicaid/CHIP measures.

"We hope that alignment focused on the universal foundation within CMS can also set the stage for alignment throughout the health care system, with improved outcomes being our collective North Star."

The Alliance of Community Health Plans, which represents integrated, nonprofit health plans, said in a statement it was "thrilled" about the new proposal.

"Consistency in a core set of quality measures reduces burden on clinicians, increases consumer understanding of quality and drives meaningful innovation. We are excited to continue to lead the industry towards high-quality care."

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