Education & Training

What are Measure Development Activities?

Technical Expert Panel

A group of persons, families, caregivers, advocates and experts who contribute direction and thoughtful input to the measure developer in every phase of the measure development process from conceptualization through maintenance.

Work Group

A work group or focus group is a small diverse group of people whose reactions are studied in guided discussions about a new or current measure that can be expected from a larger population. Work groups can meet once or multiple times depending on the needs of the project.


Occasionally, measure developers want to engage PFEN members on an individual level or reach a larger audience. Interviews and surveys are conducted to provide a thorough picture of an experience or situation. Surveys show trends while interviews add personal experience to the data that is then integrated into measure development.

What is Healthcare Quality?

Healthcare quality is defined by the National Academy of Medicine as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.  In other words, Healthcare Quality is how we determine and hold ourselves accountable to  “Doing the right thing at the right time, in the right way, for the right person, and having the best results possible.“ CMS’s quality mission is to “achieve optimal health and well-being for all individuals.”

CMS National Quality Priorities

Safety and Resiliency: The goal of safety and resiliency is  to achieve zero preventable harm and enable a responsive and resilient healthcare system to improve quality.

Outcomes and Alignment: The goal of outcomes and alignment is to improve quality and health outcomes and align coordination across programs and care settings.

Interoperability and Scientific Advancement: The goal of interoperability and scientific advancement is to accelerate and support the transition to a digital data driven health care system and transform health care using science and technology.

Equity and Engagement: The goal of equity and engagement is to advance health equity and whole person care and engage individuals and communities in their care.

Quality Measures

What is a Quality Measure?

CMS defines Quality Measures as…

"tools that help us measure or quantify health care processes, outcomes, patient perceptions, and organizational structure and/or systems that are associated with the ability to provide high-quality health care and/or that relate to one or more quality goals for health care."

What is the purpose of a Quality Measure?

Quality Measures can help us:

  • Understand how healthcare is being delivered
  • Make informed decisions
  • Improve healthcare quality

As the largest payor of healthcare in the USA the Centers for Medicare & Medicaid Services or CMS wants to improve healthcare. One way that CMS does this is through their meaningful measures initiative. CMS’s goal is to make sure everyone has high quality healthcare, optimal health and well-being.

Meaningful Measures is an initiative by CMS that identifies priority areas for quality measurement and improvement. Its goal is to improve health outcomes for persons, families, and to help healthcare providers provide high quality care. CMS collects performance measures into its database called Meaningful Measures.

You can learn more about quality measures by visiting:

Quality Measures: How they are developed, used, and maintained (

Quality Measure Development Lifecycle

The five phases of the measure lifecycle: Measure Specification, Measure Conceptualization, Measure Testing, Measure Implementation, Measure Use

The stages in the lifecycle don’t need to occur in a sequence. Often, they are happening at the same time. Quality measures are reviewed annually and every three years with consideration of the lifecycle. During quality measure reviews, patients will have the opportunity to impact measures by sharing their experiences.

Breaking down the lifecycle:
Measure conceptualization – This includes gathering information and developing a case for why this measure is important. This is how a measure is born.

Measure Specification is how a measure is built. It involves creating the foundation of the measure including the numerator and data for the measure. The data is information collected from patient information and health visits.

Measure Testing is complimentary to measure specification, this is how a measure is tested to see if it is scientifically acceptable and possible to use.

Measure Implementation are activities associated with moving a measure from development into being active or in-use. This includes collecting user input. This is how a measure is put into action.

Measure Use, Continuing Evaluation & Maintenance includes the continuous monitoring and review of how the measure is used and the impact of the measure on patients and healthcare delivery. This is how a measure is monitored.