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Measure Implementation

CMS Consensus-Based Entity (CBE) Endorsement and Maintenance

This section explains the measure steward’s/developer’s roles and responsibilities in relation to the CMS consensus-based entity’s (CBE's) measure endorsement and maintenance (E&M) processes. The Medicare Improvements for Patients and Providers Act of 2008 requires the U.S. Department of Health and Human Services (HHS) to contract with a CBE regarding performance measurement. Battelle currently serves as the CMS CBE and uses its Partnership for Quality Measurement (PQM)™ to incorporate feedback from diverse groups of interested parties to endorse measures fostering health care quality improvement. This information supplements the content found in the measure implementation and measure use, continuing evaluation, and maintenance sections of the CMS MMS Hub.


The CMS CBE endorses quality and cost/resource use measures through a transparent, consensus-based process. The CMS CBE organizes measures for endorsement by five project topical areas, each having an evaluation committee, which oversees the portfolio of measures for the topic (see table). A project consists of measures submitted by measure stewards/developers and grouped by similar topic. For more information regarding the project description, committee rosters, committee endorsement materials and proceedings, review each respective project page on the PQM website.

Project Topical Areas

Project TitleAreas CoveredExample Measures
Primary PreventionEducation, prevention, and screening related to health status and/or health risk
Initial Recognition and ManagementRecognition and timely diagnosis of conditions, including diagnostic accuracy, monitoring of early signs and symptoms of disease/condition
Management of Acute Events, Chronic Disease, Surgery, Behavioral HealthTreatment of acute events, management of chronic disease, including structural or functional changes related to chronic disease or surgery, and related outcomes
Advanced Illness and Post-Acute CareAdvanced illness and/or end-stage disease management, palliative and hospice care, post-acute care, and home care
Cost and EfficiencyTotal health care spending for a health care service or group of services associated with a specified patient population, time period, and/or unit of clinical accountability

The CMS CBE endorses measures based on a standard set of measure evaluation criteria: importance, scientific acceptability (i.e., reliability and validity), feasibility, equity, and usability and use. Currently, the equity domain is optional, as the CMS CBE recognizes that measures aren't always developed under a health equity lens. The CMS CBE continues to explore this, but to align with national priorities, the CMS CBE encourages developers and stewards to address this domain, if and when possible. Check the most recent CMS CBE evaluation criteria.

To the extent feasible, CMS uses CMS CBE-endorsed measures in CMS public reporting and value-based purchasing programs. However, measure stewards/developers may choose not to submit a measure to the CMS CBE for endorsement. CMS will consider non-endorsed measures if they meet necessary criteria.

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