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Quality Across CMS

CMS supports health care priorities by developing quality measures that address these priorities and goals, and implements them through measured entity feedback, public reporting, and links to payment incentives. CMS has long played a leadership role in quality measurement and public reporting. CMS started by measuring quality in hospitals and dialysis facilities and now measures and publicly reports the quality of care across settings of care, including nursing homes, home health agencies, physician offices, and drug and health plans. The Patient Protection and Affordable Care Act required CMS to expand quality reporting programs to include physician offices, inpatient rehabilitation facilities, inpatient psychiatric facilities, cancer hospitals, and hospices. CMS is also transforming from a passive payor to an active value purchaser by implementing payment mechanisms that reward measured entities who achieve better quality or improve the quality of care they provide. CMS is seeking to move from setting-specific, narrow snapshots to broad-based, meaningful, and person-centered assessments in the continuum of time.

In addition, CMS is committed to supporting states’ efforts to measure and improve the quality of health care for children and adults enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). CMS is building on its experiences in measured entity quality measurement and reporting to support state Medicaid programs and CHIP. CMS is mindful that state Medicaid agencies, health plans, and measured entities will want to use aligned measures that reflect beneficiary priorities, provide value, have impact, and are not administratively burdensome.

CMS contracts with external organizations to develop and implement quality measurement programs. These organizations include Quality Innovation Network-Quality Improvement Organizations, university researchers, health services research organizations, and consulting groups.

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