Quality Insights' Measures Process

Quality Insights’ measure development process is rigorous, structured and thorough.  All measures go through a series of development steps in accordance with the CMS Measures Management System (MMS) Blueprint to ensure that, when deployed, they result in the collection of meaningful data that will assist in determining quality of care.  Steps include the following:
 
  • Environmental Scan.  To determine potential measures, Quality Insights surveys current measures in the industry or topic-specific priorities.  This may include review of CMS claims data, National Quality Measures Clearinghouse, legislatively mandated health care topics, the CMS Quality Measure Development Plan and medical literature. 
  • Technical Expert Panel (TEP).   We recruit and convene TEP or expert working group participants from national organizations for medical specialty groups affected by measures under study.  These small groups consist of measure-specific providers (physicians, pharmacists and registered nurses), and may also include statisticians, quality improvement experts, methodologists, consumers, experienced measure developers, and EHR vendors to work with our team to develop and revise the measure specifications.  If you have interest in participating in a TEP, contact us
  • Public Comment.  We solicit public comment for measures.  The project team analyzes received comments for reliability and feasibility into measure development and use.
  • Measure Development.  Quality Insights prepares initial measure drafts for the TEPs, which in turn provide modifications based on expert judgment and clinical practice feasibility considerations or provide suggestions for additional measures.
  • Public Comment.  We post all proposed measures for public comment.  The project team, in concert with the TEPs and CMS, analyzes received comments for reasonability and feasibility into measure development and use.
  • Alpha Testing, We organize a group of stakeholders such as providers eligible for implementing the measures or vendors and collaborate with this group to test the measures feasibility to determine  the practicability of the constructed collection instruments  and  the availability of reportable data.
  • Beta Testing.  We field test measures for reliability and validity using provider-specific outpatient documentation. This involves electronic or chart-based record abstraction and review.
  • eCQM Testing. We conduct real-world testing for newly developed electronic clinical quality measures (eCQMs).  This unique approach ensures measures are valid, appropriate, reliable, and useful indicators of clinician performance. Testing allows measure developers to assess whether measures are or will be feasible to implement in EHRs. We provide unique work flow assessments to various sites. 
  • Endorsement Process.  We submit measures to a national accrediting body for review and endorsement.  Currently, endorsement from the National Quality Forum (NQF) is the industry gold standard.
  • Implementation.  Following CMS approval, measures are incorporated into CMS programs, such as the current Quality Payment Program. We provide annual measure maintenance and specification review and updates to maintain their relevance and align with standards.
  • Post-Implementation Testing.  Data reliability is integral to quality improvement in health care in the general population and to identifying opportunities for improvement and/or disparities in care.  Therefore, Quality Insights uses a rigorous process to conduct implementation testing to assess reliability and usability of our existing measures.  Based on this information we identify areas for improvement to the process and, consequently, strengthen the value of the measures.