There are many roles in measure development and maintenance, including measure developers, measure stewards, measured entities, and the Measures Management System (MMS). In addition to these roles, CMS encourages engagement with a variety of interested parties throughout the Measure Lifecycle. These interested parties include, but are not limited to, members of technical expert panels, persons and families, and the public.

Measure Developers

Measure developers, as directed by the measure steward, are responsible for the development, implementation, and maintenance of measures. Measure developers create, edit, and submit measures to a designated steward. CMS contracts with organizations to develop measures, but other organizations also develop measures, for example specialty societies and the National Committee for Quality Assurance. Measure developers submit measures to their assigned stewards for approval. It is also the responsibility of the measure developer to circulate their measure content for feedback and to collaborate on potential measure changes suggested by other authors or other entities. 

Measure Stewards

CMS defines measure steward as an individual or organization that owns a measure and is responsible for maintaining the measure. Measure stewards may also be measure developers. Measure stewards are the ongoing point of contact for others interested in a given measure. CMS is the steward for most measures developed under contract for CMS. Stewards have permission to approve, reject, and publish measures their assigned measure developer creates and submits. Measure stewards provide overall coordination and management of the measures created by measure developers under a specific program or for a specific purpose. Stewards are responsible for approving measure content and may withdraw measures from approval.

Measured Entities

Measured entities are the front-line clinicians and their organizations, including health information technology, collecting quality measurement data. Measured entities are the implementers of quality measures. The effect of quality measure data collection on clinician workflow can be negative. There may be effects on their payments, positive and negative, with respect to reporting and actual performance on quality measures. Because of these potential effects, measured entities should be involved in all aspects of the Measure Lifecycle.

The Measures Management System (MMS)

The MMS is a standardized system for developing and maintaining the quality measures used in CMS’s various quality initiatives and programs. The primary goal of the MMS is to provide guidance to measure developers to help them produce high-caliber health care quality measures. CMS-funded measure developers (or contractors) should follow MMS Blueprint content on the MMS Hub, which documents the core set of business processes and decisions criteria when developing, implementing, and maintaining measures.

CMS encourages measure developers who do not currently hold CMS contracts to use the CMS MMS Hub and Blueprint content as a guide in their measure development process, especially if they have a future interest in working within CMS programs. The CMS MMS Blueprint processes produce high-caliber measures that stand up to review for reliability, validity, and importance.