Why are measures important? Because when tested and implemented correctly, measures can enhance the entire health care system by allowing both clinicians and patients to make informed decisions based on the patient’s health care journey.
Battelle is a certified consensus-based entity (CBE), ensuring informed and thoughtful endorsement reviews of clinical quality and cost/resource use measures. Our Partnership for Quality Measurement (PQM)™ endorsement and maintenance (E&M) process ensures measures submitted for endorsement are evidence-based, scientifically sound, and both safe and effective (i.e., use of the measure will increase the likelihood of desired health outcomes, will not increase the likelihood of unintended, adverse health outcomes, consistent with current professional knowledge).
Endorsement adds credibility to the measures, increasing trust among patients and providers. This is especially seen when measures are undergoing consideration for use within the Centers for Medicare & Medicaid (CMS) quality reporting and value-based programs, as there is a preference for inclusion of CBE-endorsed measures. Endorsement can drive standardization of health care services, which allows for comparison of performance across providers and institutions and helps inform patient decision making.
Our measure review and endorsement process gathers input from all interested parties across the health care enterprise and develops consensus among those parties regarding which measures warrant endorsement. Our process is transparent and publicly available, allowing various interested parties to participate and engage, thus ensuring that the measures are comprehensive and relevant. Endorsement signals to the quality measurement community that measures have been reviewed by a group of diverse individuals representing a range of health care expertise and lived experiences and deemed safe, effective, and meaningful.
We organize measures for E&M by 5 project topical areas, each having an evaluation committee, which oversees the portfolio of measures for the topic (see E&M Projects). We adopt a regular schedule for measure endorsement, consisting of two six-month E&M cycles (Fall or Spring). Under the E&M process, measures submitted for endorsement review receive one of the following endorsement decisions listed in Table 1.
Table 1. Endorsement Decision Outcomes
Decision Outcome | Description |
|---|---|
| Endorsed | Applies to new and maintenance measures. There is 75% or greater agreement for endorsement by the E&M committee. |
| Endorsed with Conditions* | Applies to new and maintenance measures. The E&M committee agrees by 75% or greater that the measure can be endorsed as it meets the criteria, but committee reviewers have conditions they would like addressed when the measure comes back for maintenance. If these recommendations are not addressed, the developer/steward should provide a rationale for consideration by the E&M committee review. |
| Not Endorsed° | Applies to new measures only. There is 75% or greater agreement to not endorse the measure by the E&M committee. |
| Endorsement Removed° | Applies to maintenance measures only. Either:
|
| Endorsement Decisions from Prior CBE – No Longer In-Use± | |
| Endorsed with Reserve Status± | Applied to maintenance measures only. A measure with this decision was retained in the portfolio of measures for periodic monitoring, while also communicating to potential users that the measure no longer addresses high leverage areas for accountability purposes. |
| Approved for Trial Use± | Applied only to electronic clinical quality measures (eCQMs). “Approved for Trial Use” carries no endorsement designation but provides eCQM developers and stewards an opportunity to provide testing after the eCQM has been implemented. |
* Conditions are recommended by the E&M committee, with the consideration of what is feasible and appropriate for the developer/steward to execute by the time of maintenance endorsement review.
°Measures that fail to reach the 75% consensus threshold are not endorsed.
±Some measures may have these prior CBE endorsement decisions, but they are no longer in use under the Battelle process.
E&M Guidebook
Serving as a resource for measure stewards, measure developers, and organizations submitting measures to Battelle for endorsement review is the E&M Guidebook. This Guidebook provides information about the various steps of the E&M process, including each phased review, possible endorsement decision outcomes, the appeals process, E&M policies and procedures, and the E&M committee structure. The Guidebook also contains the PQM Measure Evaluation Rubric, a standard set of criteria against which measures submitted to Battelle are evaluated.
The E&M Guidebook is organized to provide an overview of E&M goals, priorities, and resources; to guide measure developers and stewards through the steps of the E&M process; and to provide key considerations for submitting measures to Battelle.
The E&M Guidebook evolves over time, as we are dedicated to the continued evaluation of the E&M process to address the demands of the changing health care landscape and interested party feedback. Any major changes to the E&M process, policies, or evaluation criteria undergo a formal public comment period before we implement them.
New for the Spring 2024 cycle! We are implementing several enhancements to the E&M committee roles, voting, and meeting structure. The enhancements maintain a 6-month timeline and high standards for transparency and rigor. To learn more, please review recent changes made to the E&M process.