CMS Framework for Measurement

CMS is the largest purchaser of health care in the world. In order to improve quality, safety and the delivery of high value health care for beneficiaries, CMS developed a framework for measurement that maps to the six HHS National Quality Strategy priorities. Measures should be patient-centered and outcome-oriented whenever possible.

Safety

  • Hospital-acquired conditions (HACs)
  • Health-care associated infections (HAIs)
  • Unnecessary care
  • Medication errors

Person- and Caregiver-Centered Experience and Outcomes

  • Consumer Assessment of Healthcare Providers and Systems (CAHPS) or equivalent measures for each settings
  • Functional outcomes
  • Patient experience
  • Caregiver experience
  • Preference- and goal-oriented care
  • Communication/shared decision-making

Care Coordination

  • Transition of care measures
  • Admission and readmission measures
  • Patient and family activation
  • Infrastructure and processes for care coordination
  • Impact of care coordination

Clinical Quality of Care

  • HHS primary care and CV quality measures
  • Prevention measures
  • Setting-specific measures
  • Specialty-specific measures

Population/Community Health

  • Measures that assess health of the community
  • Measures that reduce health disparities
  • Access to care and equitability measures

Efficiency and Cost Reduction

  • Spend per beneficiary measures
  • Episode cost measures
  • Quality to cost measures