What are Clinical Quality Measures?

Clinical quality measures, or CQMs, are tools that help measure and track the quality of healthcare services provided. CQMs measure 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 adherence to clinical guidelines.

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What are the CQM Requirements?

No matter if you are participating in Stage 1 or Stage 2 of the EHR Incentive program, you are required to report on 9 out of 64 CQMs in order to demonstrate meaningful use.

When selecting the CQMs to report, you must choose 3 out of 6 key health care policy domains:

  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

CMS has recommended a core set of 9 CQMs that focus on high-priority health conditions and best-practices for healthcare delivery.  The recommended core sets focus on conditions that contribute to the morbidity and mortality of most Medicare and Medicaid beneficiaries and also focus on areas that represent national public health priorities or disproportionately drive health care costs.

CMS Core Set of Recommended Clinical Quality Measures for Adult Populations1
1. Controlling High Blood Pressure
2. Use of High-Risk Medications in the Elderly
3. Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
4. Use of Imaging Studies for Low Back Pain
5. Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan
6. Documentation of Current Medications in the Medical Record
7. Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up
8. Closing the referral loop: receipt of specialist report
9. Functional status assessment for complex chronic conditions
CMS Core Set of Recommended Clinical Quality Measures for Pediatric Populations2
1. Appropriate Testing for Children with Pharyngitis
2. Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
3. Chlamydia Screening for Women
4. Use of Appropriate Medications for Asthma
5. Childhood Immunization Status
6. Appropriate Treatment for Children with Upper Respiratory Infection (URI)
7. ADHD: Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
8. Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan
9. Children who have dental decay or cavities