The Medicare Quality Monitoring System (MQMS) is part of CMS' efforts to monitor and improve the quality of care delivered to Medicare beneficiaries.

Features of MQMS include:

• Quality indicators of health care provided to Medicare beneficiaries
• Utilization and outcome quality measures for most areas, process measures for diabetes
• Based on administrative data for fee-for-service beneficiaries
• Trends from 1992 though 2001 (and in some cases beyond 2001)
• Various clinical and topic areas
  • Characteristics of Medicare beneficiaries and their utilization of health care
  • Acute myocardial infarction
  • Heart failure
  • Stroke
  • Pneumonia
  • Cardiovascular surgeries
  • Cancer surgeries
  • Diabetes preventive services utilization as well as short- and long-term complication rates
  • Patient safety
  • Preventable hospitalizations
• National and state-level outcomes (not hospital-level outcomes)
• Adjusted to a standardized distribution of age and sex; not otherwise risk adjusted
• Results generally presented by:
  • gender
  • age group
  • race/ethnicity
  • Medicaid (dual) enrollment status
  • reason for Medicare entitlement
  • urban/rural
  • census region

For each clinical or topic area, MQMS generally produces a set of reports. MQMS Highlights provide a two-page overview of key findings. Longer MQMS reports provide more detailed text and tables as well as methods.

To learn more about the MQMS, see Overview & Documentation under Downloads.

Beneficiary characteristics and utilization describes the demographic distribution of Medicare beneficiaries and rates of hospitalizations for the most common hospital diagnoses and procedures over the 1992 to 2001 time period.

Please click on the links under Downloads to access the Beneficiary Characteristics and Utilization reports.

Acute myocardial infarction (AMI) and heart failure (HF) present utilization and outcome measures for Medicare beneficiaries hospitalized for AMI and HF between the years 1992 to 2001.

Please click on the links under Downloads to access the AMI and HF reports.

Stroke presents utilization and outcome measures for Medicare beneficiaries hospitalized for stroke between the years 1992 to 2001.

Four cohorts of stroke patients are examined:

• stroke only
• stroke and transient ischemic attack (TIA)
• atrial fibrillation
• carotid endarterectomy

Please click on the links under Downloads to access the stroke reports.

Pneumonia presents utilization and outcome measures for Medicare beneficiaries hospitalized for pneumonia between the years 1992 to 2002. Three cohorts of pneumonia hospitalizations are examined:

• primary diagnosis of pneumonia
• primary diagnosis of acute respiratory failure with a secondary diagnosis of pneumonia
• primary diagnosis of septicemia with a secondary diagnosis of pneumonia

Please click on the links under Downloads to access the pneumonia reports.

Cardiovascular surgical procedures presents utilization and outcome measures for Medicare beneficiaries who had selected cardiovascular surgical procedures between the years 1992 to 2001.

Examines six surgical procedures performed on the heart and circulatory system:

• abdominal aortic aneurysm (AAA) repair
• carotid endarterectomy
• coronary artery bypass graft (CABG)
• lower extremity vascular bypass (LEBY)
• aortic valve replacement
• mitral valve replacement

Please click on the Cardiovascular and Cancer Surgeries link under Downloads to access the cardiovascular surgeries reports.

Cancer surgical procedures presents utilization and outcome measures for Medicare beneficiaries who had selected cancer surgical procedures between the years 1992 to 2001.

Examines four surgical procedures performed to treat cancer:

• lobectomy
• pneumonectomy
• pancreatectomy
• esophagectomy

Please click on the Cardiovascular and Cancer Surgeries link under Downloads to access the cancer surgeries reports.

Diabetes preventive services and complications presents rates of recommended preventive services and short- and long-term complications associated with Medicare beneficiaries who were treated for diabetes between the years 1992 and 2001.

Examines:

• preventive services (e.g. HbA1c texts, eye exams)
• short-term complications (e.g. ER visit for metabolic crisis)
• long-term complications (e.g. ESRD, lower-limb amputation)

Please click on the links under Downloads to access the diabetes reports.

Patient safety presents rates of 12 potentially preventable adverse events occurring during hospital care (from the AHRQ PSI set) among discharges of Medicare beneficiaries in the fee-for-service program in the years 2000 and 2001.

Please click on the links under Downloads to access the patient safety reports.

'Preventable hospitalizations' presents rates of ten AHRQ prevention quality indicators (PQIs) among Medicare beneficiaries between the years of 1992 and 2001.

Please click on the links under Downloads to access the preventable hospitalizations reports.

MQMS Technical Documentation

The MQMS Outcome Quality Measure Specifications, version 1.0 is a compilation of the measure specifications found in Appendix A of each individual measure report. Each chapter includes the specifications for quality measures in each MQMS areas covered by the Medicare Quality Monitoring System: beneficiary characteristics and utilization, AMI, HF, stroke, pneumonia, cardiovascular and cancer high-risk surgeries, diabetes, Patient Safety Indicators (PSI), Prevention Quality Indicators (PQI) or preventable hospitalizations.

Please click on Overview & Documentation link under Downloads to access the Outcome Quality Measure Specifications.

The MQMS Data Processing Manual, version 1.0 documents the software created for the Medicare Quality Monitoring System. This manual consists of (1) descriptions of methods used to create the software for each measure, (2) flow diagrams showing the sequence of processes and jobs used to create files and tables for a measure or a group of measures and (3) step-by-step descriptions of these processes and jobs. The manual is intended for programmers and analysts.

Please click on the Overview & Documentation link under Downloads to access the Data Processing Manual and Appendices B-I.

Downloads
Diabetes Highlights Report, Full Report and Methods, and Appendices [ZIP 3MB] Preventable Hospitalizations Highlights Report, Full Report and Methods, and Appendices [ZIP 1MB] Patient Safety Highlights Report, Full Report and Methods, and Appendices [ZIP 1MB] Beneficiary Characteristics and Utilization Full Report and Methods, and Detailed Tables [ZIP 1.3MB] AMI Highlights Report, Full Report and Methods, and Detailed Tables [ZIP 661KB] HF Highlights Report, Full Report and Methods, and Detailed Tables [ZIP 754KB] Stroke Highlights Report, Full Report and Methods, and Appendices [ZIP 1.6MB] Pneumonia Highlights Report, Full Report and Methods, and Appendices[ZIP 1.1MB]
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Page Last Modified: 09/03/2008 1:06:51 PM
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