Persons, Public, and Other Stakeholders
CMS conducts its measurement activities in a transparent manner. The information gathered through various methods described in Measure Conceptualization, informs the Department of Health and Human Services and CMS about future measurement needs. Additionally, Section 101(f) of Medicare Access and Children's Health Insurance Program Reauthorization Act requires CMS to solicit, accept, and respond to input from stakeholders, including physician specialty societies, applicable practitioner organizations, and other stakeholders for episode groups (i.e., care episode groups and patient-condition groups).
Care episode groups include those individuals whose care included similar treatments and procedures, taking into consideration individuals’ clinical diagnoses and problems during the care episode; care setting; level of acuity; and principal procedures or services furnished.
Patient-condition groups include those individuals with similar conditions, taking into consideration individuals’ medical and surgical histories, comorbid conditions, overall health status, and eligibility or dual-eligibility status.
Persons and families are extremely important stakeholders in the quality measurement enterprise, and CMS is committed to gathering their input during priorities planning. More detail about ways to hear the individual's voice is found in Person and Family Engagement and the Person and Family Engagement in Quality Measurement supplemental material.