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The Initiative

Measure Alignment

To reduce the reporting burden on professionals and focus quality efforts to achieve the greatest impact on outcomes related to the ABCS (Aspirin when appropriate, Blood pressure control, Cholesterol management, and Smoking cessation), Million Hearts® staff worked with public and private partners to align a focused set of clinical quality measures [PDF-406K] in a number of quality reporting initiatives. Tremendous measure alignment progress has been made to date. This required action, from a wide range of public and private partners who are committed to cardiovascular disease prevention, to embed the Million Hearts® CQMs into major quality reporting initiatives (Table 1).

Table 1. Million Hearts® Clinical Quality Measures Alignment–Select Reporting Systems

Quality Measures Reporting Initiative Aspirin When Appropriate Blood Pressure Screening & Follow Up Blood Pressure Control Cholesterol Management Cholesterol Management – Diabetes Cholesterol Management – Ischemic Vascular Disease Smoking Assessment and Treatment
CMS Physician Quality Reporting System (PQRS) Yes + Yes + Yes + Yes
CMS EHR Incentive Programs for Eligible Professionals Yes + Yes + + Yes Yes
National Quality Forum (NQF) Yes n/a Yes n/a Yes Yes Yes
AHA/ADA/ACS The Guideline Advantage + + + + + + +
CMS PQRS Cardiovascular Prevention Measures Group + + + n/a + + +
CMS PQRS Group Practice Reporting Option (GPRO) + + + n/a +* + +
CMS Accountable Care Organizations + + + n/a +* + +
NCQA Healthcare Effectiveness Data and Information Set (HEDIS) n/a n/a Yes n/a Yes Yes Yes
CMMI Comprehensive Primary Care n/a n/a + n/a + + +
HRSA Uniform Data System** + n/a Yes n/a n/a n/a +
CMS Medicaid Adult Core Set n/a n/a Yes n/a n/a n/a n/a
ACC PINNACLE registry n/a n/a n/a n/a n/a n/a Yes
IHS Resource and Patient Management System n/a n/a + n/a n/a n/a n/a

Quality Measures Reporting Initiative column: Bolded text = Public quality reporting initiatives; Unbolded text = Private quality reporting initiatives
“Yes” indicates measure alignment as of January 2011; “+” indicates new measure alignment as of June 2014
* Part of an all-or-nothing diabetes composite measure
**HRSA analogs: Percentage of patients aged 18 years and older who were discharged alive for acute myocardial infarction (AMI) or coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA) from January 1 to November 1 of the prior year OR who had a diagnosis of ischemic vascular disease during the measurement year who had documentation of use of aspirin or another antithrombotic; Percentage of patients 18 to 85 years of age with diagnosed hypertension (HTN) whose blood pressure (BP) was less than 140/90 at the time of the last reading; Percentage of patients age 18 years and older who were screened for tobacco use at least once during the measurement year or prior year AND who received cessation counseling intervention and/or pharmacotherapy if identified as a tobacco user.
Acronyms: CMS = Centers for Medicare & Medicaid Services, EHR = Electronic Health Record, AHA = American Heart Association, ADA = American Diabetes Association, ACS= American Cancer Society, NCQA = National Committee for Quality Assurance, HRSA = Healthcare Resources and Services Administration, ACC = American College of Cardiology, IHS = Indian Health Services


Some quality reporting initiatives use different numbering conventions for equivalent measures. The CMS Physician Quality Reporting System (PQRS) was the first reporting system to include all of the Million Hearts® clinical quality measures; Table 2 shows the numbering conventions in other reporting initiatives relative to PQRS. Please refer to official guidance from each quality reporting initiative for specific reporting methods and requirements.


Table 2. Million Hearts® Clinical Quality Measures Analog Numbering Conventions from Select Reporting Initiatives

Quality Measures Reporting Initiative Aspirin When Appropriate Blood Pressure Screening & Follow Up Blood Pressure Control Cholesterol Management Cholesterol Management – Diabetes Cholesterol Management – Ischemic Vascular Disease Smoking Assessment and Treatment
CMS Physician Quality Reporting System (PQRS) PQRS 204 PQRS 317 PQRS 236 PQRS 316 PQRS 2 PQRS 241 PQRS 226
CMS EHR Incentive Programs for Eligible Professionals CMS164v4 CMS22v4 CMS165v4 CMS61v5
CMS64v5
CMS163v4 CMS182v5 CMS138v4
National Quality Forum (NQF) NQF 0068 n/a NQF 0018 n/a NQF 0064 NQF 0075 NQF 0028
CMS PQRS Group Practice Reporting Option (GPRO) IVD-2 PREV-11 HTN-2 n/a DM-14* IVD-1 PREV-10
CMS Accountable Care Organizations ACO #30 ACO #21 ACO #28 n/a ACO #23* ACO #29 ACO #17

Quality Measures Reporting Initiative column: Bolded text = Public quality reporting initiatives; Unbolded text = Private quality reporting initiatives
* Part of an all-or-nothing diabetes composite measure



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