The CQMC is a broad-based coalition of health care leaders working to facilitate cross-payer measure alignment through the development of core sets of measures to assess the quality of health care in the United States.
Founded in 2015, the CQMC is a public-private partnership between America’s Health Insurance Plans (AHIP) and the Centers for Medicare & Medicaid Services (CMS). Over 70 member organizations, such as health insurance organizations, primary care and specialty societies, consumer and employer groups, other quality collaboratives, comprise the membership. CQMC is a membership-driven and -funded effort, with additional funding provided by CMS and AHIP. The CQMC is currently convened by Battelle’s Partnership for Quality Measurement (PQM) in its role as the consensus-based entity.
The U.S. health care system is moving from one paying for the volume of services to one paying for the value of services. Value-based payment requires quality, patient experience, and efficiency metrics to assess the success of alternative payment models and their participants at delivering value.
The increased reliance on performance measures as part of these models led to a proliferation in the number of measures and a commensurate increase in burden on providers collecting the data, confusion among consumers and purchasers seeing conflicting measure results, and operational difficulties among payers. Thus, the CQMC aims to:
- Identify high-value, high-impact, evidence-based measures promoting better health outcomes, and providing useful information for improvement, decision-making, and payment.
- Align measures across public and private payers to achieve congruence in the use of measures for quality improvement, transparency, and payment purposes.
- Reduce the burden of measurement by eliminating low-value metrics, redundancies, and inconsistencies in measure specifications and quality measure reporting requirements across payers.
The CQMC seeks to continue its work through ongoing maintenance of the existing core measure sets to reflect the changing measurement landscape, including, but not limited to, changes in clinical practice guidelines, data sources, or risk adjustment. It further seeks to expand into new clinical areas not yet addressed. In addition, the CQMC seeks to identify gaps in measurement and challenges in implementation to advance adoption of the core sets.
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Member Organizations
AAOS Registry Program
Ambulatory Surgery Center Quality Collaboration
American Academy of Pediatrics
American Heart Association
American Institutes of Research
American Psychiatric Association
American Specialty Health
AmeriHealth Caritas
Arkansas Blue Cross Blue Shield
Blue Cross and Blue Shield of North Carolina
Blue Cross Blue Shield of Michigan
CareFirst Blue Cross Blue Shield
Centene
Children's Hospital Association
College of American Pathologists
Consumers' Checkbook/Center for the Study of Services
Defense Health Agency
GI Quality Improvement Consortium, Ltd.
Health Care Transformation Task Force
Health Resources and Services Administration
Independent Health
Kentuckiana Health Collaborative
National Osteoporosis Foundation
U.S. Department of Veterans Affairs