Clinical Quality Measure Alignment
To reduce the reporting burden on professionals and focus quality efforts to achieve the greatest impact on outcomes, Million Hearts® staff worked with public and private partners to align and embed a focused set of evidence-based clinical quality measures into major quality reporting initiatives. These measures represent key outcomes related to the ABCS (Aspirin when appropriate, Blood pressure control, Cholesterol management, and Smoking cessation).
Since the launch of Million Hearts®, tremendous progress on measure alignment has been made by public and private partners. This achievement required action from a wide range of stakeholders committed to heart disease and stroke prevention, as shown in Table 1.
Table 1. Million Hearts® Clinical Quality Measures Alignment–Select Reporting Systems
| Quality Measures Reporting Initiative | Aspirin When Appropriate | Blood Pressure Screening & Follow Up | Blood Pressure Control | Cholesterol Management | Cholesterol Management – Diabetes | Cholesterol Management – Ischemic Vascular Disease | Smoking Assessment and Treatment |
|---|---|---|---|---|---|---|---|
| CMS Physician Quality Reporting System (PQRS) | Yes | + | Yes | + | Yes | + | Yes |
| CMS EHR Incentive Programs for Eligible Professionals | Yes | + | Yes | + | + | Yes | Yes |
| National Quality Forum (NQF) | Yes | n/a | Yes | n/a | Yes | Yes | Yes |
| AHA/ADA/ACS The Guideline Advantage | + | + | + | + | + | + | + |
| CMS PQRS Cardiovascular Prevention Measures Group | + | + | + | n/a | + | + | + |
| CMS PQRS Group Practice Reporting Option (GPRO) | + | + | + | n/a | +* | + | + |
| CMS Accountable Care Organizations | + | + | + | n/a | +* | + | + |
| NCQA Healthcare Effectiveness Data and Information Set (HEDIS) | n/a | n/a | Yes | n/a | Yes | Yes | Yes |
| CMMI Comprehensive Primary Care | n/a | n/a | + | n/a | + | + | + |
| HRSA Uniform Data System** | + | n/a | Yes | n/a | n/a | n/a | + |
| CMS Medicaid Adult Core Set | n/a | n/a | Yes | n/a | n/a | n/a | n/a |
| ACC PINNACLE registry | n/a | n/a | n/a | n/a | n/a | n/a | Yes |
| IHS Resource and Patient Management System | n/a | n/a | + | n/a | n/a | n/a | n/a |
Quality Measures Reporting Initiative column: bolded text = public quality reporting initiatives; unbolded text = private quality reporting initiatives.
"Yes" indicates measure alignment as of January 2011.
+ New measure alignment as of June 2014.
* Part of an all-or-nothing diabetes composite measure.
**HRSA analogs: Percentage of patients aged 18 years and older who were discharged alive for acute myocardial infarction (AMI) or coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA) from January 1 to November 1 of the prior year OR who had a diagnosis of ischemic vascular disease during the measurement year who had documentation of use of aspirin or another antithrombotic; Percentage of patients 18 to 85 years of age with diagnosed hypertension (HTN) whose blood pressure (BP) was less than 140/90 at the time of the last reading; Percentage of patients age 18 years and older who were screened for tobacco use at least once during the measurement year or prior year AND who received cessation counseling intervention and/or pharmacotherapy if identified as a tobacco user.
Acronyms: CMS = Centers for Medicare & Medicaid Services, EHR = electronic health record, AHA = American Heart Association, ADA = American Diabetes Association, ACS = American Cancer Society, NCQA = National Committee for Quality Assurance, HRSA = Health Resources and Services Administration, ACC = American College of Cardiology, IHS = Indian Health Service.
Table 2. Million Hearts® Clinical Quality Measures Analog Numbering Conventions from Select Reporting Initiatives
| Quality Measures Reporting Initiative | Aspirin When Appropriate | Blood Pressure Screening & Follow Up | Blood Pressure Control | Cholesterol Management | Cholesterol Management – Diabetes | Cholesterol Management – Ischemic Vascular Disease | Smoking Assessment and Treatment |
|---|---|---|---|---|---|---|---|
| CMS Physician Quality Reporting System (PQRS) | PQRS 204 | PQRS 317 | PQRS 236 | PQRS 316 | PQRS 2 | PQRS 241 | PQRS 226 |
| CMS EHR Incentive Programs for Eligible Professionals | CMS164v4 | CMS22v4 | CMS165v4 | CMS61v5 CMS64v5 |
CMS163v4 | CMS182v5 | CMS138v4 |
| National Quality Forum (NQF) | NQF 0068 | n/a | NQF 0018 | n/a | NQF 0064 | NQF 0075 | NQF 0028 |
| CMS PQRS Group Practice Reporting Option (GPRO) | IVD-2 | PREV-11 | HTN-2 | n/a | DM-14* | IVD-1 | PREV-10 |
| CMS Accountable Care Organizations | ACO #30 | ACO #21 | ACO #28 | n/a | ACO #23* | ACO #29 | ACO #17 |
Quality Measures Reporting Initiative column: bolded text = public quality reporting initiatives; unbolded text = private quality reporting initiatives. * Part of an all-or-nothing diabetes composite measure.
