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Endorsement & Maintenance (E&M)

The E&M process evaluates quality and cost/resource use measures to determine whether they are evidence‑based, scientifically sound (reliable and valid), safe, and effective. Measures must support desired health outcomes, avoid unintended harms, and align with current professional standards.

E&M reviews occur twice each year (Spring and Fall). Measure stewards and developers submit measures for consideration, which are reviewed by an E&M committee that determines whether to endorse the measure.

Committee Structure

• Members are appointed from PQM membership for  3‑year terms

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• There are  five E&M committees, each representing diverse health care perspectives and including two co-chairs. 
• Each committee has two subgroups: 
  • Advisory Group (Term years 1–2): Reviews measures and meets virtually to discuss strengths, limitations, and questions.
  • Recommendation Group (Term year 3): Considers all measure input (e.g., Advisory Group, public comment) and votes on endorsement decisions.

E&M Committee Time Commitment

E&M (2 cycle per year): 40–60 hours each

Includes:

• Participation in virtual meetings: 
  • Committee Orientation: September
  • Advisory Group Meetings 
    • Spring Cycle: Early July
    • Fall Cycle: Early January
  • Recommendation Group (Endorsement) Meetings 
    • Spring Cycle: Early–Mid August
    • Fall Cycle: Early–Mid February
• Review of measure submissions, public comments, and staff assessments
• Independent measure reviews using the  PQM Measure Evaluation Rubric
• Timely responses to emails, including submission of DOI forms

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Pre-Rulemaking Measure Review (PRMR) and Measure Set Review (MSR)

The PRMR and MSR processes ensure that quality measures are meaningful and appropriate for their intended programs.

• PRMR is conducted annually to provide recommendations to CMS on measures under consideration, as required by the Affordable Care Act
• MSR is conducted annually to recommend whether existing CMS program measures should continue to be used, as authorized by the Consolidated Appropriations Act, 2021

PRMR Committee Structure

• Members are appointed from PQM membership for  3‑year terms.
• Committees include individuals directly affected by measures and those with system‑level expertise.
• Membership includes  individual and organizational seats.
• Three setting‑specific committees: 
  • Hospital and Hospital‑Related Facilities
  • Clinician
  • Post‑Acute Care / Long‑Term Care (PAC/LTC)
• Each committee includes: 
  • Advisory Group:  Provides written and verbal feedback on measures.
  • Recommendation Group:  Reviews measures and makes formal recommendations.
• All members will serve on the Recommendation Group at least once during their term.
• A subset of members also serves on the MSR committee.

PRMR and MSR Committee Time Commitment

PRMR (1 cycle per year): 40–60 hours
Includes:

• Timely responses to emails, including submission of DOI forms
• Attending a virtual orientation
• Reviewing and assessing assigned measures
• Participating in a PRMR Measure Preview session
• Reviewing meeting materials
• Attending a 1–2 day PRMR Recommendations Meeting 
  • Advisory Group: Virtual
  • Recommendation Group: Virtual or in‑person (virtual always available)

MSR (1 cycle per year): ~20 hours

Includes:

• Timely responses to emails, including submission of DOI forms
• Attending a virtual orientation
• Reviewing and assessing assigned measures
• Reviewing meeting materials
• Attending a 2‑day MSR Recommendations Meeting 
  • Meetings may be in person or virtual

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