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Pre-Rulemaking Measure Review (PRMR)

New Name, Same Mission

Previously conducted via the Measure Applications Partnership (MAP) process, the annual review of measures under consideration is now called Pre-Rulemaking Measure Review (PRMR, pronounced primer).

The PRMR process is conducted yearly to provide recommendations to the Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) on the selection of quality and efficiency measures under consideration for use by HHS, as required under Section 3014 of the "Patient Protection and Affordable Care Act of 2010" (ACA) (P.L. 111-148) which created section 1890A of the Social Security Act.


The Guidebook of Policies and Procedures for Pre-Rulemaking Measure Review (PRMR) and Measure Set Review (MSR) is now available for download. The Guidebook provides an overview of the PRMR and MSR policies and procedures, associated timelines, measure selection and removal criteria, a summary of the committee compositions, and how committees will be engaged via the Novel Hybrid Delphi and Nominal Group (NHDNG) technique.

Goals & Focus
To ensure measures on the MUC List are reasonable and necessary to CMS
programs and target populations
Within program-target population
PRMR Overview

* Novel Hybrid Delphi and Nominal Group: This is a multi-step process increase engagement of all members and structure facilitation by using standard criteria and practices. The approach allows committees to maximize the value of the time spent by focusing discussion on measures where there is disagreement.
† MSR  consists of only a recommendation approach and follows a modified NHDNG process. 

PRMR Committees

Working Together for Real-World Results

Advisory group input guides the recommendation group conversations working in tandem to provide meaningful impact on measures.

A cross-program approach for an integrated and aligned process, PRMR will be guided by three overarching committees, each including an advisory group and a recommendation group, to provide input into measure reviews:

  • Hospital Committee
  • Clinician Committee
  • Post-Acute Care/Long-Term Care (PAC/LTC) Committee

PRMR committees are structured into an advisory group and a recommendation group. Members of the advisory group review and provide recommendations on measures prior to recommendation group meetings. These inputs ensure that a larger number of voices contribute to the consensus-building process. 

PRMR Committee Structure
New Novel Hybrid Delphi and Nominal Group Technique

The PRMR evaluation processes entail iterative review of measures. The review process is a combination of Battelle-led assessments (Staff Assessments) and input from the committee members. This multi-step process is meant to increase engagement of all members and structure facilitation by using standard criteria and practices. PRMR uses a modified NHDNG technique to build consensus among committee members, leveraging experienced facilitators.  

PRMR Process Workflow

Contact [email protected] for more information on the NHDNG technique.