CMS has contracted with Mathematica Policy Research and its partners to develop, electronically specify, test, and maintain electronic clinical quality measures (eCQMs) for potential opioid overuse. Mathematica is recruiting ambulatory practices and hospitals to participate in testing 5 eCQMs that may be used in federal quality reporting programs, such as the Merit-Based Incentive Payment System (MIPS).
There are two phases of testing, as follows:
- Phase I: In the early stages of testing, the subcontractor will interview staff and examine clinical workflows and current EHR capacity. The goal of this phase of testing is to determine if the measure is feasible to implement in the current health care environment.
- Phase II: In the latter stages of testing, the subcontractor will work closely with practices and hospitals to access electronically and manually abstracted EHR data that are required for the measure calculation. The goal of this phase of testing is to assess the reliability and validity of the measure.
Benefits to participating practices and hospitals:
- Practices will directly contribute to the refinement and validation of eCQMs that CMS will consider for use in its quality reporting programs, such as MIPS.
- Practices gain insight into quality measurement that could help them refine their internal quality improvement efforts.
- Practices selected as testing sites will be eligible for an incentive payment of up to $4,000 for participation (see chart below).
Following is a summary of the eCQMs, the incentives involved and the projected time commitment:
| eCQM | eCQM Description | Incentive | Time Commitment |
| Potential Opioid Overuse | Percentage of patients aged 12 years or older who receive opioid therapy for 90 days or longer and who are prescribed a 120 milligram or greater morphine milligram equivalent (MME) daily dose. | $4000 | 16-week period, which will involve an estimated time commitment of 17 to 26 hours |
| Changes in Functional Status Following Elective Percutaneous Coronary Intervention (PCI) | Percentage of patients aged 18 years and older who undergo a qualifying elective PCI procedure with documented improvement in self-reported functional status using a combination of disease-specific patient reported outcome measures (PROMs). | $2000 | 12-week period, with an estimated time commitment of 8 to 12 hours depending on the contracting process and the number of clinician interviews that are completed. |
| Inappropriate Use of PCI in Asymptomatic Patients | Percentage of patients aged 18 years and older who undergo an elective PCI without angina, atypical angina, or anginal equivalent symptoms. | $2000 | 12-week period, with an estimated time commitment of 8 to 12 hours depending on the contracting process and the number of clinician interviews that are completed. |
| Annual Wellness Assessment | The percentage of patients age 65 or older with an annual wellness visit during the measurement period who received age- and sex-appropriate preventative care assessments, screenings, and vaccinations. | $4000 | 14 weeks at most, with an estimated time commitment of 16 to 23 hours |
| HIV Screening | HIV Screening: Percentage of patients between the ages of 15 and 65 who had an outpatient visit during the measurement period who have a documented HIV test during the measurement period. | $4000 | 16-week period, with an estimated time commitment of 22 hours |
If you are interested in participating or would like more information, please contact healthpolicy@aapmr.org.