The Centers for Medicare & Medicaid Services (CMS)  states that clinical quality measures (CQMs) are tools that measure and track the quality of healthcare services provided by eligible professionals (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs) within our healthcare system. Continuously measuring and reporting CQMs helps ensure the delivery of safe, effective, efficient, patient-centered, and timely care.

CQMs encompass many aspects of patient care including: health outcomes, clinical processes, patient safety, efficient use of healthcare resources, care coordination, patient engagement, population and public health, and clinical guidelines.

Beginning in 2014, for Meaningful Use (MU) stages 1 and 2, providers are required to report on nine CQMs.  Likewise for both Meaningful Use Stages 1 and 2, providers only have to report on a 90-day period in 2014, regardless of the year or stage of Meaningful Use they are in. However, they must be using a 2014 certified EHR at the beginning of that 90-day period.  NextGen Healthcare became ONC certified in March 2013 and was one of the first EHR vendors in the country to be certified. NextGen® Ambulatory EHR version 5.8 is our 2014 certified version for both Meaningful Use stages 1 and 2. NextGen® Electronic Dental Record (NextGen EDR) version 4.3 is a certified Dental EDR when used in conjunction with NextGen Ambulatory EHR.

Understanding CQMs for 2014

CMS has identified six core healthcare policy domains that encompass patient care. They include:

  1. Patient and Family Engagement
  2. Patient Safety
  3. Care Coordination
  4. Population and Public Health
  5. Efficient Use of Healthcare Resources
  6. Clinical Processes/Effectiveness

Learn more about MU.   Download our Meaningful Use eBook!

9/64 and 3/6

All eligible providers must select three CQMs from the six national quality strategy healthcare domains listed above.  Beginning in 2014, regardless of the MU stage, EPs will be required to report on nine out of 64 clinical quality measures from at least three of the six key healthcare policy domains listed above.

A “Method to the Madness”

Many clients have asked what criteria CMS used in selecting the specific core set of measures. The answer is that CMS selected the recommended core set of CQMs based on analysis of health conditions that:

  • Contribute to the morbidity and mortality of the most Medicare and Medicaid beneficiaries
  • Represent national public health priorities
  • Are common to health disparities
  • Disproportionately drive healthcare costs and could improve with better quality measurement
  • Enable CMS, states, and providers to measure quality of care in new dimensions, with a stronger focus on economic measurement
  • Include patient and/or caregiver engagement

This strategy supports Health Reform’s “Triple Aim” to:

  • Improve the patient experience of care (including quality and satisfaction);
  • Improve the health of populations; and
  • Reduce the per capita cost of healthcare

Adult CQM Reporting

This is the list of recommended CQMs released by CMS for adult populations. You may recognize some of these as existing measures in 2013.

  • Controlling High Blood Pressure
  • Use of High-Risk Medications in the Elderly
  • Preventive Care and Screening:  Tobacco Use:  Screening and Cessation Intervention
  • Use of Imaging Studies for Low Back Pain
  • Preventive Care and Screening:  Screening for Clinical Depression and Follow-Up Plan
  • Documentation of Current Medications in the Medical Record
  • Preventive Care and Screening:  Body Mass Index (BMI) Screening and Follow-Up
  • Closing the referral loop: receipt of specialist report
  • Functional status assessment for complex chronic conditions

Pediatric CQM Reporting

  • Appropriate Testing for Children with Pharyngitis
  • Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
  • Chlamydia Screening for Women
  • Use of Appropriate Medications for Asthma
  • Childhood Immunization Status
  • Appropriate Treatment for Children with Upper Respiratory Infection (URI)
  • ADHD: Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
  • Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan
  • Children who have dental decay or cavities

Get more information about Meaningful Use.

NextGen Healthcare clients, access the NextGen Healthcare Meaningful Use Resource Center:

  • Live and web training classes
  • Educational webinars
  • FAQs
  • Meaningful Use Stage 2 Client Pathway document
  • HQM White Papers
  • Listing of upcoming training sessions (check Training Portal frequently)