Clinical Quality Measures (CQM) Overview for 2014

Eligible Professionals (EP’s) who demonstrate 2014 clinical quality measures (CQMs) will need to report 9 measures. CQMs may be reported electronically, or via attestation.

There is also a new requirement in 2014 that the quality measures selected must cover at least 3 of the 6 available National Quality Strategy (NQS) domains, which represent the Department of Health and Human Services’ NQS priorities for health care quality improvement.

The 6 NQS domains are:
1. Patient and Family Engagement
2. Patient Safety
3. Care Coordination
4. Population/Public Health
5. Efficient Use of Healthcare Resources
6. Clinical Process/Effectiveness

View the 2014 CQM Electronic Reporting Guides for Eligible Professionals to learn more about 2014 CQMs and the reporting process.

Recommended Core Set

For 2014, CMS is not requiring the submission of a core set of electronic CQMs (eCQMs). Instead, CMS has identified two recommended core sets of eCQMs—one for adults and one for children—that focus on high-priority health conditions and best-practices for care delivery.

9 eCQMs for adult populations that meet all of the program requirements
9 eCQMs for pediatric populations that meet all of the program requirements

drchrono supports reporting all of the 9 eCQMs for adult populations and 1 of the 9 eCQMs for pediatric populations

Denominator, Numerator, Exclusion and Exception

The authoritative resource for this explanation is the Clinical Quality eMeasure Logic and Implementation Guidance Document that is publicly available on the CMS Site, but details have been paraphrased and summarized for provider convenience below:

Initial Patient Population: The set of patients (or episodes of care) to be evaluated by the measure.

Denominator Population: A subset of the Initial Patient Population.

Exclusion Population: The members of the Denominator that should not be considered for inclusion in the Numerator.

Numerator Population: A subset of the Denominator. The numerator criteria are the processes or outcomes expected for each patient, procedure, or other unit of measurement defined in the denominator.

Exception Population: These are the members of the Denominator that were considered for membership in the Numerator, but were rejected, and meet the logic required for the exception criteria.

 

These final population counts are then used to calculate the performance rate of any CQM against a population of patients via the following formula:


Performance Rate = Numerator Count / (Denominator Count – Exclusion Count – Exception Count)

For CQM providers do not need to report performance rate; only Denominator, Numerator, Exclusion and Exception are required.

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