On December 22, 2020, Centers for Medicare & Medicaid Services (CMS) released the 2020 list of Measures Under Consideration (MUC). The MUC is a list of quality and efficiency measures, based on data collected from providers, under consideration for adoption as rules under Medicare. The 2020 measures focus on reducing the administrative burden on providers, prioritizing health outcomes, and encouraging digital innovation, particularly regarding data collection and evaluation.
In accordance with the Meaningful Measures Initiative of 2017, digital innovation remains a top priority for CMS in developing quality measures. The Meaningful Measures Initiative was created to reduce the regulatory and reporting burden on providers and focuses on identifying the highest priority areas for quality improvement and measurement to improve patient outcomes. Since its launch, the Meaningful Measures Initiative has provided better quality metrics that are relevant to various providers. The 2020 MUC follow the Meaningful Measures Initiative by focusing on goals such as creating trackable and measurable outcomes, reducing healthcare disparities, cost efficiency, the modernization of reporting mechanisms, and reducing administrative obstacles for providers so they can better focus on quality care for patients, rather than paperwork. A majority of the measures utilize digital collection of data, rather than requiring providers to use traditional pen-and-paper data collection.
The 2020 MUC include:
- Five process measures. These represent measures to improve standardized best practices. The process measures include kidney health evaluations, implementations for individuals with pre-diabetes, treatment for those with ST-Segment Elevation Myocardial Infarction (STEMI) involving the calculation of data based on electronic health records, and three measures related to the COVID-19 vaccine, which utilize the tracking of vaccine coverage in various healthcare facilities.
- Five outcome measures. Outcome measures are those that focus on Medicare healthcare results. These measures include the rate of healthcare related infections that necessitate the hospitalization of residents in skilled nursing facilities, the hospitalization ratio of dialysis patients, and the percentage of beneficiaries who received certain breast screening studies that were followed by other specific images or screenings such as mammograms or MRI’s.
- Five cost/resource use measures. These are measures that examine the frequency with which certain healthcare items are used and how much they cost, including an evaluation of melanoma resection services, medical treatment related to sepsis, colon and rectal resection, and episode-based costs associated with the treatment of diabetes and asthma/chronic obstructive pulmonary disease.
- Three composite measures. Composite measures evaluate the overall quality of care using a combination of two or more variables to create as singular quality measure, and include a hospice care index, a global malnutrition composite score, and a measure of the percentage of patients who receive certain preventive screenings and wellness services.
- Two patient reported outcome measures. Information from these measures comes directly from the patient, related to a patient’s feelings when experiencing a certain disease or condition. These include patient reported outcomes related to Elective Primary Total Hip and/or Total Knee Arthroplasty (THA/TKA) and a measure based on a patient’s relationship with a provider or practice.
For over 35 years, Wachler & Associates has represented healthcare providers and suppliers nationwide in a variety of health law matters, and our attorneys can assist providers and suppliers in understanding new developments in Medicare and other CMS rules and regulations. If you or your healthcare entity has any questions pertaining to healthcare compliance, please contact an experienced healthcare attorney at 248-544-0888 or wapc@wachler.com.