This section discusses the implementation process, CMS pre- and rulemaking processes (measure selection), and measure rollout. Quality measure implementation includes all activities associated with progressing a measure from the development state into an active, in-use state, including consensus endorsement processes, measure selection processes, and measure rollout. 

Factors Impacting Implementation 

Measure implementation processes vary depending on the program in which the implementation occurs. There is a statutory requirement for some CMS programs to use the pre-rulemaking and rulemaking processes for measure selection. The process of implementing measures varies significantly from one measure set to another, depending on a number of factors: 

• Scope of measure implementation
• Measured entity
• Data collection processes
• Ultimate use of the measure (e.g., quality improvement, public reporting, pay-for-reporting, value-based purchasing)
• Program into which the measure is adopted

The scope of measure implementation could entail a measure or measure set being 

• Implemented in a new program
• Added as a new measure or measure set for an existing program
• Put forth for CMS consensus-based entity endorsement

Measure Lifecycle