CMS releases shorter Measures Under Consideration list
The CMS released its Measures under Consideration (MUC) list for 2018 pre-rulemaking. The agency also sent the MUC to the National Quality Forum for input.
The new list includes 32 measures that the CMS said has “the potential to drive improvement in quality across numerous settings of care, including clinical practices, hospitals and dialysis facilities,” wrote Kate Goodrich, MD, director for the Center for Clinical Standards & Quality and CMS’ chief medical officer. The list is much shorter than last year's, when CMS considered almost 100 measures.
The CMS is also “considering new measures to help quantify healthcare outcomes and track the effectiveness, safety and patient-centeredness of the care provided,” said Goodrich.
An ongoing theme at CMS this year is reducing reporting burdens with a goal of implementing meaningful quality measures. Administrative burden associated with quality initiatives is a common complaint among providers.
Goodrich said the agency created the list to include items that ensure measures considered for adoption "focus on clearly defined, meaningful measure priority areas that safeguard public health and improve patient outcomes.”
The CMS considered 184 measures offered by healthcare stakeholders when devising the MUC list. The agency narrowed the list to 32 measures that reflect “high-quality healthcare and meaningful outcomes for patients while minimizing burden,” she wrote.
About 40% of measures on this year’s list are outcome measures that the CMS said will empower patients to make healthcare decisions and help providers make “continuous improvements in the care provided.” The list also includes eight episode-based cost measures.
The CMS recently announced the “Meaningful Measures” initiative that will focus on high-priority areas to improve quality without having the CMS “micromanage and measure processes,” according to CMS Administrator Seema Verma. Through the initiative, the CMS will take quality measuring advice from Health Care Payment Learning & Action Network, National Academies of Medicine, Core Quality Measures Collaborative and National Quality Forum.
The move to a more a value-based payment system is progressing, but barriers remain for providers. A recent study by the American Academy of Family Physicians and Humana found that more family physicians are participating in value-based payment models and are providing care coordination. However, family physicians cited the same barriers as a similar study two years ago, including a lack of: staff time, transparency between payers and providers, standardization of performance measures and uniform payer performance reports.
Nearly all experts agree that value-based care and payments are the future, but administrative burdens and physician fears about risk remain an issue with quality-driven projects. Providers welcome the CMS’ constant drumbeat about reducing administrative burdens, but issues involving workload, evaluation and burnout haven't been resolved yet.