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Clinical Quality Measures

As part of the requirements for achieving Meaningful Use as defined by the Centers for Medicare and Medicaid Services (CMS), eligible professionals will be required to report ambulatory clinical quality measures (CQMs) to CMS or the States.

Eligible professionals (EPs) must report from a list of 44 clinical quality measures, including 3 Core, 3 Alternate Core, and 38 additional CQMs.

The 3 core CQMs are:

  1. Hypertension: Blood Pressure Measurement
  2. Preventive Care and Screening Measure Pair: a) Tobacco Use Assessment, and b) Tobacco Cessation Intervention
  3. Adult Weight Screening and Follow-up
If one or more of the 3 core measures does not apply to an EP’s practice, the EP must select and report on one or more of the 3 alternate core CQMs:
  1. Weight Assessment and Counseling for Children and Adolescents
  2. Preventive Care and Screening: Influenza Immunization for Patients 50 years old or older
  3. Childhood Immunization Status
EPs must also select 3 additional CQMs from a set of 38 (see list below).

To summarize, EPs must report on 6 total measures: 3 required core measures (substituting alternate core measures where necessary) and 3 additional measures.

In 2011, EPs can submit CQM data by attestation. However, in 2012, EPs will be required to electronically submit CQM data.

For further information visit the Centers for Medicare and Medicaid website.

Core Set

  1. Hypertension: Blood Pressure Measurement
  2. Preventive Care and Screening Measure Pair: a) Tobacco Use Assessment, b) Tobacco Cessation Intervention
  3. Adult Weight Screening and Follow-up

Alternate Core Set

  1. Weight Assessment and Counseling for Children and Adolescents
  2. Preventive Care and Screening: Influenza Immunization for Patients 50 years old or older
  3. Childhood Immunization Status

Additonal Set

  1. Diabetes: Hemoglobin A1c Poor Control
  2. Diabetes: Low Density Lipoprotein (LDL) Management and Control
  3. Diabetes: Blood Pressure Management
  4. Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)
  5. Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI)
  6. Pneumonia Vaccination Status for Older Adults
  7. Breast Cancer Screening
  8. Colorectal Cancer Screening
  9. Coronary Artery Disease (CAD): Oral Antiplatelet Therapy Prescribed for Patients with CAD
  10. Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)
  11. Anti-depressant medication management: (a) Effective Acute Phase Treatment, (b)Effective Continuation Phase Treatment
  12. Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation
  13. Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy
  14. Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
  15. Asthma Pharmacologic Therapy
  16. Asthma Assessment
  17. Appropriate Testing for Children with Pharyngitis
  18. Oncology Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR) Positive Breast Cancer
  19. Oncology Colon Cancer: Chemotherapy for Stage III Colon Cancer Patients
  20. Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients
  21. Smoking and Tobacco Use Cessation, Medical Assistance: a) Advising Smokers and Tobacco Users to Quit, b) Discussing Smoking and Tobacco Use Cessation Medications, c) Discussing Smoking and Tobacco Use Cessation Strategies
  22. Diabetes: Eye Exam
  23. Diabetes: Urine Screening
  24. Diabetes: Foot Exam
  25. Coronary Artery Disease (CAD): Drug Therapy for Lowering LDL-Cholesterol
  26. Heart Failure (HF): Warfarin Therapy Patients with Atrial Fibrillation
  27. Ischemic Vascular Disease (IVD): Blood Pressure Management
  28. Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic
  29. Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: a) Initiation, b) Engagement
  30. Prenatal Care: Screening for Human Immunodeficiency Virus (HIV)
  31. Prenatal Care: Anti-D Immune Globulin
  32. Controlling High Blood Pressure
  33. Cervical Cancer Screening
  34. Chlamydia Screening for Women
  35. Use of Appropriate Medications for Asthma
  36. Low Back Pain: Use of Imaging Studies
  37. Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control
  38. Diabetes: Hemoglobin A1c Control (<8.0%)

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