The Centers for Medicare & Medicaid Services (CMS) has posted the electronic clinical quality measure (eCQM) specifications for the 2021 reporting period for eligible hospitals and critical access hospitals, and the 2021 performance period for eligible professionals and eligible clinicians. CMS updates the specifications annually to align with current clinical guidelines and code systems so they remain relevant and actionable within the clinical care setting. These updated eCQMs are to be used to electronically report 2021 clinical quality measure data for CMS quality reporting programs. Measures will not be eligible for 2021 reporting unless and until they are proposed and finalized through notice-and-comment rulemaking for each applicable program.
CMS has updated eCQMs for potential inclusion in the following programs:
- Hospital Inpatient Quality Reporting Program
- Medicare and Medicaid Promoting Interoperability Programs
- Quality Payment Program: The Merit-based Incentive Payment System and Advanced Alternative Payment Models (APMs)
- APM: Comprehensive Primary Care Plus
- APM: Primary Care First
Where to Find the Updated eCQM Specifications and Materials
The updated eCQM specifications are available on the eCQI Resource Center for eligible hospitals and critical access hospitals and eligible professionals and eligible clinicians under the 2021 Reporting/Performance Year. Other eCQM resources, including the Guide for Reading eCQMs, eCQM Logic and Implementation Guidance, tables of eCQMs, and technical release notes, are also available at the same locations. The Guide to Reading eCQMs and eCQM Logic and Implementation Guidance have been updated based on end user feedback and CMS continues to update these guides to assist stakeholders in understanding and implementing eCQMs.
Where to Find the 2021 eCQM Value Sets, Direct Reference Codes, and Terminology
The 2021 reporting/performance period eCQM value sets are available through the National Library of Medicine’s Value Set Authority Center (VSAC). The value sets are available as a complete set, as well as value sets per eCQM. The direct reference codes specified within the eCQM HQMF files are also available in a separate file for download on the VSAC Downloadable Resources page.
The eCQI Resource Center includes information about CMS pre-rulemaking eCQMs. CMS pre-rulemaking eCQMs include measures that are developed, but specifications are not finalized for reporting in a CMS program. At this time, there are two pre-rulemaking eCQMs for eligible professionals and eligible clinicians and no pre-rulemaking eCQMs for eligible hospitals and critical access hospitals. These measures will not be eligible for CMS quality reporting until they are proposed and finalized through notice-and-comment rulemaking for each applicable program. Please visit the pre-rulemaking eCQM pages for eligible hospitals and critical access hospitals and for eligible professionals and eligible clinicians to learn more. The pre-rulemaking eCQM value sets for use in the pre-rulemaking eCQMs are available through the VSAC.
Hospital Hybrid Measures Information
The eCQI Resource Center includes information about CMS hybrid measures for eligible hospitals and critical access hospitals. A hybrid measure is a quality measure that uses both claims data and clinical data from electronic health records for calculating the measure. Please visit the new hybrid measures page on the eCQI Resource Center to learn more. The hybrid measure value sets for use in the hybrid measures are available through the VSAC.
Quality Data Model Update
CMS has published a guidance update for the Quality Data Model version 5.5. The referenced document clarifies some of the definitions and fixes minor errata noted in the document initially published to the eCQI Resource Center in August 2019.
For More Information
To find out more about eCQMs, visit the eCQI Resource Center.
Visit the eCQM Data Element Repository which is a searchable module in the eCQI Resource Center that provides all the data elements associated with eCQMs in CMS quality reporting programs, as well as the definitions for each data element. This information is intended to improve clarity for those implementing eCQMs.
For Questions Regarding eCQMs To report questions or comments on the eCQM specifications, visit the eCQM Issue Tracker. Note that an ONC Project Tracking System (Jira) account is required to ask a question or comment.