Must-know tips for clinical quality measure reporting

All practitioners in both programs will now report on the same set of quality measures.

Clinical quality measure (CQM) reporting continues to be required to demonstrate meaningful use in Medicare and Medicaid electronic health records (EHRs) incentive programs in 2014.

CMS has identified 64 clinical quality measures for potential use in the EHR incentive programs. These measures will be used in both Stage 1 and Stage 2 meaningful use.

Practitioners must report on nine of the government's 64 approved CQMs. In addition, selected CQMs must cover at least three of the U.S. Department of Health & Human Services' National Quality Strategy priority areas or "domains."

6 National Quality Strategy domains

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

CMS identified core sets of recommended, but not required, CQMs for adult or pediatric populations. Many of these CMS-recommended measures do not apply to the optometric practice; as such, optometrists should review the approved CQMs to determine which measures they plan to report. Included below is a list of CQMs identified by AOA which many optometrists may find apply to their practice.

  • Controlling High Blood Pressure
  • Use of High-Risk Medications in the Elderly
  • Weight Assessment and Counseling for Nutrition and Physical Activity For Children and Adolescents
  • Preventive Care and Screening: Tobacco Use Screening and Cessation Intervention (NQF 0028)
  • Diabetes Eye Exam
  • Primary Open Angle Glaucoma: Optic Nerve Evaluation
  • Diabetic Retinopathy Documentation of Presence of Absence of Macular Edema and Level of Severity of Retinopathy
  • Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
  • Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up
  • Cataracts: Complications within 30 days following cataract surgery requiring additional surgical procedures
  • Cataracts: 20/40 or better visual acuity within 90 days following cataract surgery
  • Documentation of Current Medications in the Medical Record
  • Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up

View the complete list of CQMs for the EHR incentive programs.

Resources for understanding CMQs

Also starting in 2014, all Medicare-eligible providers beyond their first year of demonstrating meaningful use must report CQM data electronically. Stage 1 EHR users must still provide aggregate numerator, denominator and exclusions through attestation to meet meaningful use criteria (or be part of the CMS' PQRS Electronic Reporting Pilot). Those optometrists participating in the Medicaid EHR program will electronically report their CQM data to their state.

The AOA offers online resources for navigating EHR programs (member log-in required). In addition, CMS offers guidance and a tip sheet related to CQMs.

January 31, 2014

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