Key Activities by Stage

The graphic depicts a high-level view of the major tasks involved in developing measures, from initial measure conceptualization through measure implementation and maintenance. Note the circular design of the graphic with multiple bidirectional arrows. Measure developers can adjust the sequence or carry out steps concurrently and iteratively. Measure developers conduct feasibility evaluation, information gathering, and interested party engagement on an ongoing basis throughout the Measure Lifecycle. CMS and other interested parties are working to shorten the measure timeline for more rapid development and implementation of new measures. 

Measure Lifecycle Stages

There are five stages in the Measure Lifecycle: conceptualization; specification; testing; implementation; and use, continuing evaluation, and maintenance. Measure developers start with measure conceptualization, however, the stages are not necessarily sequential, but instead are iterative, and can occur concurrently. 

• The measure conceptualization stage initiates information gathering and business case development.
• The measure specification stage involves establishing the basic elements of the measure, including the numerator, calculation algorithm, and data source identification.
• The measure testing stage examines the specifications, usually with a limited number of real settings, to make sure the measure is scientifically acceptable and feasible.
• Measure specification and measure testing are iterative. The measure implementation stage begins with measure selection through various processes and then measure rollout.
• The measure use, continuing evaluation, and maintenance stage involves continued monitoring of the measure’s use, performance, importance, accuracy, and impact on individuals and the delivery of care.

The Outcome

The end product of measure development is a precisely specified, valid, and reliable measure that is meaningful to clinicians, individuals, and caregivers.