With today’s comprehensive Meaningful Measures initiative, CMS has refocused healthcare quality measures on improving patient needs and experiences, reducing regulatory burden on clinicians, and removing barriers to value-based payment. The evolved quality measures center on patient, clinician, and health system needs and strategic goals to truly impact improving care and lowering costs. Meaningful Measures, according to CMS, must meet seven criteria: Are patient-centered and meaningful to patients, clinicians, and providers. Address high-impact measure areas that safeguard public health. Are outcome-based where possible. Minimize the level of burden for providers. Create significant opportunity for improvement. Address measure needs for population-based payment through alternative payment models. Align across programs.

1. Evolving CMS Quality Measures Move
Towards More Patient-Centered Care

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Though developed to ensure that health
systems deliver effective, safe, efficient,
patient-centered, equitable, and timely
care, CMS clinical quality measures don’t
always match organizational, clinician,
and patient interests and priorities.
Quality measures, however, remain
critical as health systems continue to
build strategies and processes around
value-based payment.
CMS Quality Measures for Patient-Centered Care

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Today, CMS is increasingly aligning
measures with health system goals.
Organizations can now empower
themselves around regulatory
requirements, turning measures into
an opportunity for improvement, and
no longer a burden.
CMS Quality Measures for Patient-Centered Care

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CMS is listening to health system concerns with focus in key areas:
CMS Quality Measures for Patient-Centered Care
How quality
measures can
hinder optimal
patient care.
Moving towards
value with
existing barriers
and existing fee-
for-service (FFS)
incentives.
Changing the
reimbursement
infrastructure to
curtail the industry’s
upward spending
trajectory.

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Under the current approach, health
systems that work with CMS and
communicate their quality-reporting
challenges and goals have an
opportunity to help move themselves
and the healthcare industry more
effectively towards value-based care.
CMS Quality Measures for Patient-Centered Care

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The CMS comprehensive Meaningful
Measures initiative identifies high-
priority areas for quality measurement
and improvement.
The framework aims to improve
outcomes for patients, their families,
and health systems while also reducing
burden on clinicians and providers.
To qualify as meaningful under the CMS
criteria, measures must help move
payment toward value by focusing
the healthcare industry on the same
quality areas.
Today’s Quality Measures Prioritize Patient Care

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Meaningful Measures must meet certain criteria:
Are patient-centered and meaningful to patients, clinicians, and providers.
Address high-impact measure areas that safeguard public health.
Are outcome-based where possible.
Minimize the level of burden for providers.
Create significant opportunity for improvement.
Address measure needs for population-based payment
through alternative payment models.
Align across programs.
Today’s Quality Measures Prioritize Patient Care
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Under the Meaningful Measures Initiative,
CMS has identified high-impact areas for
quality measurement and improvement.
Meaningful Measures quality categories
and their 19 corresponding areas are
available on the CMS website.
The Meaningful Measures Framework
(Figure 1) places the patient at the center
of CMS strategic goals, with customer
experience, flexibility in state and local
leadership, innovation, and patient
empowerment as the strategic goals.
Targeting High-Impact Areas for Quality
Measurement and Improvement

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The framework aims to give health
systems and payers more granular
details about measurement areas,
offer a leaner and more patient-
centric approach to developing and
implementing meaningful quality
measures, and reduce the burden
of quality reporting on clinicians
and providers.
Targeting High-Impact Areas for Quality
Measurement and Improvement
Figure 1: The Meaningful Measures Initiative (CMS. Accessed January 2019.)

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The Patients Over Paperwork initiative
solidifies the CMS commitment to putting
patients first and reducing unnecessary
regulatory burdens on clinicians.
An important aim of Patients Over
Paperwork is to “de-duplicate” certain
measures that occur in multiple programs.
The initiative keeps the measures in the
programs where they can best incentivize
improvement.
Reducing Regulatory Burden

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This will mean removal of 18 measures
and de-duplication of 25.
For example, under a proposed 2019
rule change to the inpatient prospective
payment system (IPPS), when incentives
appear around the same event in several
programs, CMS will limit incentives to
only the most necessary programs, so
the clinicians aren’t reporting the same
event multiple times.
Reducing Regulatory Burden

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The initiative gives health systems an
internal process to evaluate and streamline
regulations, increase efficiencies, and
improve the patient experience.
Meaningful Measures are part of the
Patients Over Paperwork; other steps
include simplifying office visit document-
ation, mapping the nursing home
experience, reducing burden through
coding and documentation reform, and
other key barriers to optimal care.
Reducing Regulatory Burden

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CMS has designed the Meaningful Measures initiative to
better support patients, health systems, and clinicians.
To get the most from the changes under
the Meaningful Measures initiative—optimal
reimbursement—health systems need
data- and analytics-driven tools to best
understand measures and make sure
they’re integrated with the overall
quality landscape.
Three Tools to Empower Health Systems Around
Evolving Regulatory Measures

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Tools that strengthen executive decision
support, population health review, and
benchmarking, for example, can help
organizations (and their patients and
clinicians) thrive as regulatory
measures evolve:
Executive Decision Support
Population Health Review
Benchmarking
Three Tools to Empower Health Systems Around
Evolving Regulatory Measures
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1. Executive Decision Support
Three Tools to Empower Health Systems Around
Evolving Regulatory Measures
A new-generation executive decision support
tool, such as Health Catalyst® Leading
Wisely, can help health systems orient their
teams around the same quality topics to
minimize additional burden and drive care.
Using personalized watch-lists, configurable
visualizations, and customizable alerts and
notifications, Leading Wisely gives
organizations one source to view key
measures and goals to strategize, balance,
and optimize performance.

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2. Population Health Review
Three Tools to Empower Health Systems Around
Evolving Regulatory Measures
Another Health Catalyst tool, the Community Care Advanced Application
caters to primary care clinical program leaders, primary care providers and
care coordinators in ambulatory settings, quality improvement teams, and
staff responsible for reports related to the organization’s status as an ACO.
Community Care gives organizations data to review population health:
Compare their performance to national benchmarking
standards for specific measures.
Identify opportunities for costs savings.
Track, monitor, and meet the needs of high-risk patients.

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3. Benchmarking
Three Tools to Empower Health Systems Around
Evolving Regulatory Measures
Health systems can use a next-
generation benchmarking tool (e.g.,
Health Catalyst Touchstone™) to
understand events that factor
heavily in CMS measures, including
readmissions and mortality.
Touchstone is an AI-enabled tool
that shows organizations where
they’re performing well and where
than can improve along the
continuum of care.

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3. Benchmarking
Three Tools to Empower Health Systems Around
Evolving Regulatory Measures
Health systems can empower themselves
by assessing how their strategic plans align
not only with CMS measures but also with
external ranking reports.
There are many programs and an
abundance of quality measures, making it
increasingly important to prioritize measures
that improve quality of care and resist the
distractions of variable metric definitions as
each new report comes out.

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Transforming Compulsory Measures to Empower
Health Systems, Patients, and Clinicians
Quality measures don’t need to make
healthcare organizations feel powerless.
By using data and analytics to find
efficiencies in how they structure quality
measures strategies and aligning
strategic goals, health systems can
improve experiences for their patients
and clinicians while delivering higher
quality, more cost-effective care.

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Transforming Compulsory Measures to Empower
Health Systems, Patients, and Clinicians
With Meaningful Measures, CMS is clearly
listening to health system and clinician
concerns and making sure its guidelines and
requirements are meaningful to all involved in
healthcare delivery, most notably the patient.
With increasingly patient- and clinician-centered
initiatives, CMS has made concrete efforts to
respond to industry needs and concerns.
Healthcare organizations that take this invitation
to strategize around the increasingly patient-
centered CMS approach are most likely to
thrive in the evolving regulatory landscape.

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For more information:
“This book is a fantastic piece of work”
– Robert Lindeman MD, FAAP, Chief Physician Quality Officer

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More about this topic
Link to original article for a more in-depth discussion.
Evolving CMS Quality Measures Move Towards More Patient-Centered Care,
Less Burden for Clinicians
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Varying Degrees of Readiness ― Bobbi Brown, MBA, Sr. VP; Dorian DiNardo, Sr. VP of Analytics
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Josh Ferguson APRN, ACNP, ANP-BC, VP of Clinical Outcomes Improvement
Clinically Meaningful Quality Metrics Improve the Provider Experience
Health Catalyst Success Story

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Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
Britney joined Health Catalyst in January 2015 as a Program Manager for Regulatory
Reporting and Operations through the Allina Health partnership. Prior to Allina Health she
worked for the CDC’s Prevention Research Center, in Minneapolis, conducting a program
evaluation on adolescent health. Britney has a Master of Public Health degree from the
University of Minnesota.
Britney Rosenau

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Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
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