About CMS Person and Family Engagment

Quality Measures and Person and Family Engagement

Centers for Medicare & Medicaid Services (CMS) uses measures in its quality improvement, public reporting and pay-for-reporting programs to improve the quality of healthcare for their beneficiaries. CMS understands the importance of the unique perspective and expertise of the person, family caregivers and the medical professionals who provide care in the measure development process. CMS takes a leadership role in collaborating with a broad group of stakeholders that includes persons and families on the development, implementation, and maintenance of clinical quality measures to make sure the measures are important to both patients, families, and clinicians and to represent important performance gaps in the targeted quality measures.

 

“At CMS, our overall vision is to reinvent the agency to put patients first. We want to partner with patients, providers, payers, and others to achieve this goal. We aim to be responsive to the needs of those we serve.”

Administrator Seema Verma

Centers for Medicare and Medicaid Services, 2017

The Five Phases of the Quality Measure Development Cycle

CMS manages a standardized approach for developing and maintaining quality measures that are used in various quality initiatives and programs. This approach comprises a set of business processes and decision criteria that CMS-funded measure developers follow in the development, implementation, and maintenance of quality measures.

CMS’ process for developing and implementing quality measures across topics and objectives can be summarized into five main stages; conceptualization, specification, testing, implementation and the use and continuation of the measure. At each stage, person families, advocates and other stakeholders can participate and give their insight that will influence the rest of the quality measure development.

  1. Conceptualization: Develop measure concepts and then narrow down to specific measures.
  2. Specification: Identify the population, the recommended practice, the expected outcome, and determine how it will be measured.
  3. Testing: Assess the suitability of the quality measure’s technical specifications and acquire empirical evidence to help assess the strengths and weaknesses of a measure.
  4. Implementation: Identify measures to submit for the CMS selection and rollout processes, adopt measures into CMS programs, and seek endorsement.
  5. Use, Continuing Evaluation, and Maintenance: Ensure that the measure continues to add value to quality reporting measurement programs and that its construction continues to be sound.

Measures and Person and Family Engagement

CMS conducts its measurement activities in a transparent manner. Information gathered through various methods informs CMS about future measurement needs. Stakeholders are persons or organizations with a vested interest or concern related to clinical quality measures. CMS strives for measures that are patient-centered, relevant and will improve outcomes for patients, their families and providers while also reducing burden on clinicians and providers. Person and family engagement are important to achieving this goal.

Want to get involved?

CMS is particularly interested in integrating the unique perspective and expertise of a broad range of stakeholders, including those of persons, family, caregivers and the clinicians and professionals who provide care in the measure development process. Enhancing existing activities and promoting broader engagement are critical to an ongoing and successful partnership among organizations developing measures.