Clinical Quality Measure Alignment

To reduce the reporting burden on clinicians and focus quality efforts to achieve the greatest impact on outcomes, Million Hearts® staff worked with public and private partners to align and embed a small set of clinical quality measures into major national programs. High performance on these measures will accelerate progress in preventing heart attack and stroke, kidney and heart failure, and cognitive decline.

Since the launch of Million Hearts®, tremendous progress on measure alignment has been made by public and private partners. This achievement required action from a wide range of stakeholders committed to heart disease and stroke prevention, as shown in Table 1.

Table 1. Million Hearts® Clinical Quality Measures Alignment in Select National Programs

 
Primary Measures
Secondary Measures
Programs
Aspirin When Appropriate
Blood Pressure Control
Cholesterol Management
Smoking Assessment and Treatment
Cardiac Rehab Referrals (From Inpatient or Outpatient Sites)
Body Mass Index (BMI)
CMS Quality Payment Program (QPP) Yes Yes Yes Yes Yes Yes
  • CMS QPP—Cardiology Specialty Group
Yes Yes Yes Yes Yes Yes
  • CMS QPP—Internal Medicine Specialty Group
Yes Yes Yes Yes Yes Yes
  • CMS QPP—General/Family Medicine Speciality Group
Yes Yes Yes Yes Yes Yes

CMS Comprehensive Primary Care Plus (CPC+) initiative

Yes Yes Yes Yes No Yes
ABFM PRIME Registry Yes Yes Yes Yes No Yes
AHRQ EvidenceNow Yes Yes Yes Yes No No
HRSA Uniform Data Systema (UDS) Yes Yes Pendingb Yes No Yes
National Quality Forum (NQF) Yes Yes No Yes Yes Yes
AHA The Guideline Advantage Yes Yes No Yes No Yes
ACP Genesis Registry Yes Yes No Yes No Yes
CMS Shared Savings Program Yes Yes No Yes No Yes
CMS Transforming Clinical Practice Initiative (TCPi) Yes Yes No Yes No Yes
HHQI Home Health Cardiovascular Data Registry Yes Yes No Yes No No
Core Quality Measures Collaborativec Yes Yes No Yes No Yes
IHS Resource and Patient Management System No Yes Pendingb Yes No Yes
ACC PINNACLE Registry No Yes No Yes Yes No
CMS Medicaid Adult Core Set No Yes No Yesd No No
NCQA Healthcare Effectiveness Data and Information Set (HEDIS) No No No Yesd No No

Programs column: bolded text = public programs; unbolded text = private programs.
“Yes” Indicates measure alignment as of July 2017.
Acronyms: BMI = Body Mass Index, CMS = Centers for Medicare & Medicaid Services, QPP = Quality Payment Program; CPC+ = Comprehensive Primary Care Plus, ABFM = American Board of Family Medicine, AHRQ = Agency for Healthcare Research and Quality, HRSA = Health Resources and Services Administration, UDS = Uniform Data System, NQF = National Quality Forum, AHA = American Heart Association, ACP = American College of Physicians, TCPi = Transforming Clinical Practice Initiative, IHS = Indian Health Service, ACC = American College of Cardiology, NCQA = National Committee for Quality Assurance, HEDIS = Healthcare Effectiveness Data and Information Set, HHQI = Home Health Quality Improvement.

aHRSA analogs: Percentage of patients aged 18 years or older who were discharged alive for acute myocardial infarction (AMI) or coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA) in 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 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; Percentage of patients aged 18 or older who had documentation of a calculated BMI during the most recent visit or within the six months prior to that visit and if the most recent BMI is outside parameters, a follow-up plan is documented.

bCurrently in development; measure will be added for reporting in 2019 after e-specifications are released in May 2017.
cCore Measure Collaborative is led by the America’s Health Insurance Plans (AHIP) and its member plans’ Chief Medical Officers, leaders from CMS, and the National Quality Forum.
dClose measure analog.

Table 2. Million Hearts® Clinical Quality Measures Analog Numbering Conventions

 
Primary Measures
Secondary Measures
Programs
Aspirin When Appropriate
Blood Pressure Control
Cholesterol Management
Smoking Assessment and Treatment
Outpatient Cardiac Rehab Referrals
Inpatient Cardiac Rehab Referrals
Body Mass Index (BMI)
CMS Quality ID 204 236 438 226 243 n/a 128
CMS eMeasure ID CMS164 CMS165 CMS347 CMS138 n/a n/a CMS69
National Quality Forum (NQF) NQF 0068 NQF 0018 n/a NQF 0028 NQF 0643 NQF 0642 NQF 0421
CMS Shared Savings Program ACO-30 ACO-28 n/a ACO-17 n/a n/a ACO-16

Programs column: bolded text = public program; unbolded text = private program.

Acronyms: CMS = Centers for Medicare & Medicaid Services, NQF = National Quality Forum, ACO = Accountable Care Organization.

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