Clinical Quality Measures

About Clinical Quality Measures

Clinical quality measures (CQMs) are tools which help measure and track the quality of healthcare services Eligible Professionals, Eligible Hospitals, and Critical Access Hospitals provide. Measuring and reporting CQMs helps to ensure that our healthcare system is delivering effective, safe, efficient, patient-centered, equitable, and timely care. CQMs measure many aspects of patient care, including:

  • Patient and Family Engagement
  • Patient Safety
  • Care Coordination
  • Population/Public Health
  • Efficient Use of Healthcare Resources
  • Clinical Process/Effectiveness

Submitting CQMs

EPs are no longer required to report CQMs based on 3 National Quality Domains. EPs may report any 6 (self-selected) CQMs from the list of 53 available CQMs here. CMS is aligning the specific CQMs available to EPs participating in the Medicaid Promoting Interoperability Program with those available to professionals participating in the Merit-based Incentive Payment System removing 11 CQMs (see table below) from the list of 64 CQMs.

  • CMS61v6 – Preventive Care and Screening: Cholesterol – Fasting Low Density Lipoprotein (LDL-C) Test Performed
  • CMS62v5 – HIV/AIDS: Medical Visit
  • CMS64v6 – Preventive Care and Screening: Risk-Stratified Cholesterol -Fasting Low Density Lipoprotein (LDL-C)
  • CMS77v5 – HIV/AIDS: RNA Control for Patients with HIV
  • CMS126v5 – Use of Appropriate Medications for Asthma
  • CMS140v5 – Breast Cancer: Hormonal Therapy for Stage I (T1b)-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR) Positive Breast Cancer
  • CMS141v6 – Colon Cancer: Chemotherapy for AJCC Stage III Colon Cancer Patients
  • CMS148v5 – Hemoglobin A1c Test for Pediatric Patients
  • CMS163v5 – Diabetes: Low Density Lipoprotein (LDL-C) Control (< 100 mg/dL)
  • CMS179v5 – ADE Prevention and Monitoring: Warfarin Time in Therapeutic Range
  • CMS182v6 – Ischemic Vascular Disease (IVD): Complete Lipid Profile and LDL-C Control (<100 mg/dL)

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