Electronic Clinical Quality Measures (eCQMs) Updates for 2019

Electronic Clinical Quality Measures (eCQMs) Updates for 2019

The Centers for Medicare & Medicaid Services (CMS) have posted the 2019 eCQMs updates including the 2019 reporting period for Eligible Hospitals and Critical Access Hospitals (CAH), and the 2019 performance period for Eligible Professionals and Eligible Clinicians.

According to the eCQI Resource Center:

eCQMs use detailed clinical data to assess the outcomes of treatment by healthcare providers and organizations, reduce the burden of manual abstraction and reporting for provider organizations, and foster the goal of access to real-time data for bedside quality improvement and clinical decision support.

The eCQMs are updated annually by CMS to align with current clinical guidelines to remain useful in the clinical care setting. The updated eCQMs are to be used to report 2019 clinical quality measure data for CMS quality reporting programs.

Per the eCQI Resource Center, CMS has updated eCQMs for potential inclusion in the following programs:

  • Comprehensive Primary Care Plus (CPC+)
  • The Hospital Inpatient Quality Reporting (IQR) Program
  • The Medicaid Promoting Interoperability Program (formerly known as the Medicaid EHR Incentive Program)
  • The Medicare Promoting Interoperability Program (formerly known as the Medicare Electronic Health Record (EHR) Incentive Program)
  • Quality Payment Program: The Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs)

Changes for 2019 Reporting/Performance  

Clinical Quality Language use (CQL) – in 2019, the reporting CQMs will be expressed with the new CQL standard for logic expression. The Quality Data Model will continue to be used as the conceptual model to convey clinical concepts.

Take a look at the current version of the CQL standard and the QDM v5.3 Annotated version to get a feel for how these programs work together to provide eCQMs that can be read by humans and structured for electronic processing.

eCQM Reading Guide – Use this resource to understand eCQMs as it provides information on eCQMs like file naming conventions, QDM data criteria, value sets, and so much more.

2019 eCQM Value Set Updates  

CMS along with the National Library of Medicine (NLM) will release updates to the electronic clinical quality measure (eCQM) value sets to align with the most recent terminology releases including, but not limited to:

  • Current Procedural Terminology (CPT)
  • International Classification of Diseases (ICD)-10 Clinical Modification (CM)
  • LOINC
  • Procedure Coding System (PCS)
  • RxNorm
  • SNOMED CT

What programs will be affected by the addendum?

The addendum was published in September 2018 to update relevant eCQM value sets for the 2019 reporting/performance year. The following programs will be affected:

  • CMS Hospital Inpatient Quality Reporting (IQR)
  • Comprehensive Primary Care Plus (CPC+)
  • Medicare and Medicaid Promoting Interoperability (PI) programs
  • The Quality Payment Program: Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs)

What changes are included in the addendum?

The changes in the addendum will affect the value sets for eCQMs only. The Health Quality Measure Format (HQMF) specifications, the value set object identifiers (OIDs), and the 2019 measure version numbers for eCQM reporting will not change. Changes to the value sets consist of the following:

  • Deletion of expired codes
  • Addition of relevant replacement codes
  • Addition of new codes representing consistent concepts with the intent of the value set and corresponding measures

Where to find the addendum  

The eCQM value set changes are available through the NLM’s Value Set Authority Center. You’ll find the value sets as a complete set, as well as value sets per measure. You can find updated measure information on the eCQI Resource Center website.

What do I need to do?

Review the changes to assure submissions comply with the updated requirements.

Where do I go for assistance?

Questions about the addendum, eCQM value sets, and mapping appropriateness can be sent to the ONC eCQM Issue Tracker.

For more frequently asked questions and answers regarding the addendum, visit the eCQI Resource Center.

Where to Find the Measure Specification Updates

The 2019 updates can be found on the eCQI Resource Center:

If you’d like to offer feedback on the updated measures, you can visit the eCQM Issue Tracker, set up an account and ask questions or make comments.

Visit the eCQI Resource Center for more information.

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