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Blueprint Measure Lifecycle

Measure Implementation

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

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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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