On January 4, 2012, the Secretary of Health and Human Services (“HHS”) issued a final notice in the Federal Register announcing the initial set of 26 quality measures for Medicaid-eligible beneficiaries, which covers areas including prevention, care coordination, and chronic disease management. The Affordable Care Act required HHS to issue such measures by January 1, 2012 and complete certain actions over the next two years – establish a Medicaid Quality Measurement Program, create a standardized reporting format for the core set of adult quality measures and procedures to encourage voluntary reporting by the States, annually publish certain recommended changes to the initial measures, and collect, analyze, and make publicly available the information reported by the States.
Identification of the 26 quality measures is an important first step in an overall strategy to encourage and enhance quality improvement for the Medicaid population. CMS worked with the Agency for Healthcare Research and Quality to develop the measures, some of which are already being used by CMS’ EHR incentive program, the Medicare Physician Quality Reporting System, and the Medicare Shared Savings Program. HHS will launch a Technical Assistance and Analytic Support Program to help States collect, report, and use the voluntary core set of adult measures and, over the next year, CMS will phase in components of the Medicaid Adult Quality Measures Program that will help to further identify measurement gap areas and begin testing the collection of some of the initial core measures.
It should be noted that any Medicare-certified ACO will be subject to the 33 quality measures issued this past November by CMS in its Final ACO Rule. It is likely that there will be considerable overlap between the 33 quality measures published last year and these 26 quality measures.