2014 REGULATORY CHANGES...
adults and one for children. We encourage
eligible professionals to report from the
recommended core set to the extent those
CQMs are applicable to your scope of practice
and patient population.
Eligible Hospitals and CAHs
must report on 16 of
the 29 approved CQMs
Selected CQMs must cover at least 3 of the
National Quality Strategy domains (See
“Measure Selection Process” below.)
EPs must report on 9 of
the 64 approved CQMs
Beginning in 2014, all Medicare-eligible
providers beyond their first year of
demonstrating meaningful use must
electronically report their CQM data to
CMS. (Medicaid EPs and hospitals that are
eligible only for the Medicaid EHR
Incentive Program will electronically
report their CQM data to their state.) See
“Reporting Options for EPs” and
“Reporting Options for Eligible Hospitals
and CAHs” below for more information.
Recommended core CQMs – encouraged
but not required
• 9 CQMs for the adult population
Adult Recommended Core Measures
• Controlling High Blood Pressure
• Use of High-Risk Medications in the Elderly
• Preventive Care and Screening: Tobacco
Use: Screening and Cessation
Intervention
• Use of Imaging Studies for Low Back Pain
• Preventive Care and Screening: Screening
for Clinical Depression and Follow-Up Plan
• Documentation of Current Medications in
the Medical Record
• Preventive Care and Screening: Body Mass
Index (BMI) Screening and Follow-Up
• Closing the referral loop: receipt of
specialist report
• Functional status assessment for complex
chronic conditions
Measure Selection Process
CMS selected the recommended core set of
CQMs for EPs based on analysis of several factors:
• Conditions that contribute to the morbidity
and mortality of the most Medicare and
• Medicaid beneficiaries
• Conditions that represent national public
health priorities
• Conditions that are common to health
disparities
• Conditions that disproportionately drive
healthcare costs and could improve with
better quality measurement
• Measures that would enable CMS, States, and
the provider community to measure quality
of care in new dimensions, with a stronger
focus on parsimonious measurement
• Measures that include patient and/or
caregiver engagement
• 9 CQMs for the pediatric population
Pediatric Recommended Core Measures
• Appropriate Testing for Children with
Pharyngitis
• Weight Assessment and Counseling for
Nutrition and Physical Activity for Children
and Adolescents
• Chlamydia Screening for Women
• Use of Appropriate Medications for Asthma
• Childhood Immunization Status
• Appropriate Treatment for Children with
Upper Respiratory Infection (URI)
• ADHD: Follow-Up Care for Children
Prescribed Attention-Deficit/Hyperactivity
Disorder (ADHD) Medication
• Preventive Care and Screening: Screening
for Clinical Depression and Follow-Up Plan
• Children who have dental decay or cavities
In addition, CMS selected all CQMs to align
with the Department of Health and Human
Services’ National Quality Strategy priorities
for health care quality improvement...
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