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Blueprint Measure Lifecycle

Measure Conceptualization

This section discusses the main components of measure conceptualization: information gathering and business case development, each of which plays a critical role throughout the Measure Lifecycle.

Measure conceptualization initiates the Measure Lifecycle. It includes identification of measure concept(s) by researching and scanning the environment. This exploration encompasses researching a variety of sources, analyzing measure gaps, conducting other types of analyses, developing a business case, and engaging multiple interested parties. The end goal of measure conceptualization is a meaningful, well-researched measure concept with well-defined initial components (e.g., target/initial population, denominator, numerator).

To develop a successful measure, a measure developer should

  • Identify the end goal of the measure, e.g., this measure seeks to improve XX.
  • Identify the intended end use of the measure, e.g., is this for hospital quality reporting program, population health/Accountable Care Organizations, or solely for quality improvement projects.
  • Explicitly identify a need for the measure as a high priority area.
  • Prioritize outcome and patient-reported outcome measures, equity, and digital measures.
  • Identify how to collect the measure data through standardized electronic data elements.

Resources for Existing Measures

Before beginning measure development, measure developers should consider whether to adopt or respecify an existing related or competing measure to fit the desired purpose. Examples of resources measure developers may use to identify existing measures are CMS Measures Inventory Tool, the Submission Tool and Repository (STAR) Measure Database, and Qualified Clinical Data Registry (QCDR) lists of measures. To review QCDR measures, go to the Quality Payment Program Explore Measures & Activities website. If the measure developer does not identify a measure that matches the desired purpose, they should work with a Technical Expert Panel (TEP) to develop a new measure. The TEP considers concepts and measures throughout the information gathering process, including application of the measure evaluation criteria.

Measure Lifecycle

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  • Determine the measure ingredients and calculation formula
  • Collect input and testing findings on initial measure specifications to aid in refinement
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  • Includes annual update and comprehensive reevaluation every 3 years
  • Early maintenance review may be necessary
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  • Identify ideas or topics that are most important to interested parties and address a gap in measurement
  • Scan the environment
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  • Collect qualitative and quantitative data to establish whether the measure meets evaluation criteria
  • Iterate with Measure Specification
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  • Pre- and rulemaking processes
  • Collect user input on initial measure specifications to aid in refinement
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