MAP Final Reports 

Effective March 27, 2023, NQF is no longer the contracted consensus-based entity (CBE) for the Centers for Medicare & Medicaid Services (CMS). Battelle will serve as the CMS CBE for the Measure Applications Partnership (MAP). Materials posted to this site through the 2022-2023 Measures Under Consideration (MUC) cycle will continue to be available to the public. However, any materials for the 2023 Measure Set Review (MSR) and 2023-2024 MUC cycles and beyond can be found on the Battelle Partnership for Quality Measurement (PQM) website.

Please visit the Battelle PQM website at https://p4qm.org/ for more information.

The Measure Applications Partnership is a public-private partnership convened by the National Quality Forum (NQF) to provide input to the Department of Health and Human Services (HHS) on the selection of performance measures.

On September 23, 2022, MAP submitted the following report to HHS:

1. The Measure Applications Partnership (MAP), convened and facilitated by the National Quality Forum (NQF), is a multi-stakeholder group that provides consensus-based recommendations for the selection and removal of measures from federal quality and performance programs. MAP’s recommendations for removal of measures in the selected programs reflect priorities to ease burden associated with increased number of performance measures, and identify measures that no longer meet program priorities and no longer provide valuable information for public reporting and payment programs. During the 2022 Measure Set Review (MSR) cycle, MAP reviewed 32 measures across six programs. Of the 32 measures, MAP expressed support for retaining 9 measures, conditional support for retaining for 16 measures, conditional support for removal for 4 measures, and support for removal for 3 measures. Access Final Report
    

On March 3, 2022, MAP submitted the following report to HHS:

1. The Measure Applications Partnership (MAP), convened and facilitated by the National Quality Forum (NQF), is a multi-stakeholder group that provides recommendations to the Centers for Medicare & Medicaid Services (CMS) on the selection of performance measures for federal health programs.   During the 2021-22 cycle, MAP reviewed 29 measures under consideration, with two measures considered for two programs and one measure considered for seven programs. MAP’s pre-rulemaking recommendations for measures in these programs reflect the MAP Measure Selection Criteria (MSC) and how well the measures address the goals of the program. In addition, NQF launched the Health Equity Advisory Group, with CMS funding, to review all measures under consideration to ensure that perspectives on health inequities and disparities were adequately considered. Access Final Report
    

On October 21, 2021, MAP submitted the following report to HHS:

1. For the 2021-2022 Measure Applications Partnership (MAP) cycle, NQF collaborated with the Centers for Medicare & Medicaid Services (CMS) and the MAP Coordinating Committee to define a pilot process for Measure Set Review (MSR). The goal of this effort was to offer a holistic review of quality measures with input from diverse multistakeholders. This cycle focused on developing a process for review and creating criteria for evaluating measures within federal programs. 22 measures within select Hospital programs were reviewed during this pilot cycle. Measures that warranted the highest level of strategic discussion were those concerning condition-specific readmission measures versus hospital-wide readmission measurement. Committee members highlighted Hospital Star Ratings Programs, which were the focus of prior NQF reports, indicating that greater focus should be placed on units treating specific conditions in hospitals rather than generic ratings. Additionally, Committee members identified MSR as an opportunity to step back from individual measure scrutiny to broadly look at the role of quality measurement and programs in achieving desired health outcomes. Access Final Report
    

On March 11, 2021, MAP submitted the following report to HHS:

1. The Measure Applications Partnership (MAP) provides multistakeholder pre-rulemaking input to the Centers for Medicare & Medicaid Services (CMS) on measures under consideration for payment and reporting programs. During the 2020-21 cycle, MAP reviewed 20 measures under consideration, with one measure considered for two programs and one measure considered for eight programs. The measures reviewed included five process measures (including three COVID-19 vaccination measures), five cost/resource use measures, five outcome measures, three composite measures, and two patient reported outcomes performance measures (PRO-PMs). The MAP acknowledged current trends shifting services from inpatient to ambulatory services and the implications for measurement in both settings. The MAP also emphasized the importance of mitigating measurement burden and the opportunities offered by electronic clinical quality measures and other digital measures. Additionally, the MAP recognized the critical role of measurement in addressing the COVID-19 healthcare crisis. Access Final Report
    

On March 13, 2020, MAP submitted the following report to HHS:

1. The Measure Applications Partnership (MAP) provides multistakeholder, pre-rulemaking input to the Centers for Medicare & Medicaid Services (CMS) on measures under consideration for payment and reporting programs. During the 2019-2020 cycle, MAP reviewed measures under consideration for the following programs: Merit-Based Incentive Payment System (MIPS), Medicare Shared Savings Program (SSP), and Medicare Part C and D Star Ratings. MAP emphasized the importance of shared accountability for performance measures of hospital admissions, readmissions, and emergency department use that are incorporated into public reporting and payment programs. Additionally, MAP noted that the current phase of the opioid crisis is predominantly driven by an increased uptake of fentanyl-laced heroin leading to increases in overdose and death. MAP acknowledged an important shared responsibility for individual providers, health systems, and health plans to address issues of pain management and function as well as to identify and address issues associated with opioid use disorder (OUD). Access Final Report
    

On February 14, 2020, MAP submitted the following reports to HHS:

1. The Measure Applications Partnership (MAP) Hospital Workgroup reviewed six measures under consideration (MUC) for four hospital and setting-specific programs. MAP emphasized that patients and consumers value patient safety measures in public accountability programs, and facilities can improve patient safety through quality improvement programs. Additionally, MAP discussed the importance of a system-level measurement approach to identify priorities across settings, such as transfer of health information measures and electronic clinical quality measures (eCQMs). MAP expressed support for the CMS Meaningful Measures Initiative: MAP recommended priority gaps to consider and monitoring for the shift of services traditionally delivered in the hospital into ambulatory settings. Access Final Report 
   
   
2. The Measure Applications Partnership (MAP) provides multistakeholder, pre-rulemaking input to the Centers for Medicare & Medicaid Services (CMS) on measures under consideration for payment and reporting programs. During the 2019-2020 cycle, MAP reviewed two measures under consideration, one each for the following programs: Home Health Quality Reporting Program (HH QRP) and Hospice Quality Reporting Program (Hospice QRP). MAP identified care coordination, interoperability, and patient-reported outcomes (PROs) as the most important priorities for measurement for post-acute care (PAC) and long-term care (LTC) programs. MAP emphasized the importance of including the voice of the patient and patient-centered goals in quality measurement. MAP noted the potential impact of technology and interoperability, especially on care coordination. Additionally, MAP emphasized the need to engage with electronic health record vendors and PAC/LTC facilities, align measurement across the full continuum of care, and address quality measure gaps. Access Final Report

On August 31, 2018, MAP submitted the following reports to HHS:

1. The 2018 final report, Strengthening the Core Set of Healthcare Quality Measures for Adults Enrolled in Medicaid, is the NQF Medicaid Adult Committee’s sixth set of annual recommendations to the U.S. Department of Health and Human Services (HHS) for strengthening the Core Set of Healthcare Quality Measures for Adults Enrolled in Medicaid (Adult Core Set). The Medicaid Adult Workgroup supported the continued use of 31 of 33 measures in the Adult Core Set and recommended eight new measures for phased addition to help improve quality in high-priority areas such as home and community-based services, substance use, and behavioral health. To inform future revisions to the Adult Core Set, the Adult Workgroup discussed gap areas that lack adequate metrics for measuring improvement, challenges states face in reporting measures, and strategies to increase overall Adult Core Set reporting.
   
   
2. The 2018 final report, Strengthening the Core Set of Healthcare Quality Measures for Children Enrolled in Medicaid and CHIP, is the Measure Applications Partnership’s (MAP) fifth set of annual recommendations to the U.S. Department of Health and Human Services (HHS) for strengthening the Core Set of Healthcare Quality Measures for Children Enrolled in Medicaid and/or CHIP (Child Core Set). MAP supported the continued use of all current measures in the 2018 Child Core Set, and recommended the phased addition of six measures. MAP recommended measures that address high-priority gap areas such as behavioral health, care coordination, and chronic health conditions such as sickle cell disease. During this Core Set review cycle, discussion focused on the overall lifespan needs of the Medicaid/CHIP population and the relationship between health and social risk factors. The measure gaps were reprioritized, and a broad population-health based framework was created to include clinical and nonclinical/nonmedical setting measures to best address existing gaps in measurement. MAP also discussed focusing on maximizing data utility and lowering data collection burden as an approach to improving quality measurement and Child Core Set reporting at the state level.
   

In February 2018, MAP submitted the following reports to HHS:

1. The Measure Applications Partnership (MAP) reviewed one measure under consideration for the Skilled Nursing Facility Quality Reporting Program (SNF QRP). MAP’s pre-rulemaking recommendation for the measure in this program reflect the MAP Measure Selection Criteria, how well the measure address the identified program goals, and MAP’s guidance for priorities in post-acute and long term care. In addition, MAP identified measurement gaps for five setting-specific programs addressing post-acute care (PAC) and long-term care (LTC). During its review of the measures, MAP identified several overarching themes including: (1) Aligning measures to address critical quality issues, (2) Addressing crucial measurement gaps, and 3) Improving the impact of measurement. This report, MAP 2018 Considerations for Implementing Measures in Federal Programs - Post-Acute Care and Long-Term Care, explores those issues in further detail.
   
   
2. The Measure Applications Partnership (MAP) Hospital Workgroup reviewed measures under consideration for five hospital and setting-specific programs. MAP recognized the need for parsimony and harmonization of measures across programs. As CMS continues to transition to value-based purchasing and alternative payment models, MAP noted that appropriate evidence must inform the measures chosen for use, and those measures must be shown to be reliable and valid. Finally, MAP discussed potential criteria for measure removal from federal programs. MAP supported measure removal criteria that CMS suggested. MAP put forward related considerations regarding unintended consequences, provider burden and operational issues, appropriate risk adjustment, and consumer value. This report, MAP 2018 Considerations for Implementing Measures in Federal Programs - Hospitals, explores those issues in further detail. 

On August 31, 2017, MAP submitted the following reports to HHS:

1. The 2017 final report, Strengthening the Core Set of Healthcare Quality Measures for Adults Enrolled in Medicaid, is the Measure Applications Partnership’s (MAP’s) fifth set of annual recommendations to the U.S. Department of Health and Human Services (HHS) for strengthening the Core Set of Healthcare Quality Measures for Adults Enrolled in Medicaid (Adult Core Set). MAP supported the continued use of all but two of the 30 measures in the Adult Core Set and recommended four new measures for phased addition to help improve quality in high-priority areas such as reproductive health, care for people with asthma, and substance use. To inform future revisions to the Adult Core Set, MAP prioritized gap areas that lack adequate metrics for measuring improvement, discussed continued challenges states face in reporting measures, and suggested strategies to improve the Adult Core Set measures.
   
   
2. The 2017 final report, Strengthening the Core Set of Healthcare Quality Measures for Children Enrolled in Medicaid, is the Measure Applications Partnership’s (MAP) fourth set of annual recommendations to the U.S. Department of Health and Human Services (HHS) for strengthening the Core Set of Healthcare Quality Measures for Children Enrolled in Medicaid/CHIP (Child Core Set). MAP supported the continued use of all but five of the current measures in the Child Core Set, and recommended the phased addition of five measures to assess and improve access to care, behavioral health, and care for people with asthma. To inform future revisions to the Child Core Set, MAP prioritized previously identified gap areas that lack adequate metrics for measuring improvement and emphasized the need for better alignment of measures, data integration and linkage, and stratification. MAP also noted the need for measures that capture and address long-term outcomes and provide actionable information for quality improvement.
   
   
3. The 2017 final report, Promoting Integrated and Coordinated Care that Addresses Social Risk for the Dual Eligible Beneficiary Population, is the Measure Applications Partnership’s (MAP’s) latest set of recommendations to the U.S. Department of Health and Human Services (HHS) for performance measures that can improve healthcare services and value for individuals eligible for both Medicare and Medicaid. These beneficiaries are some of the most vulnerable individuals accessing the healthcare system and supportive services, often experiencing disabling disease and complex social circumstances with limited resources. MAP supports the removal of eight measures from the Dual Eligible Beneficiaries Family of Measures as well as the addition of five measures to the Family. MAP discusses strategic issues including the need for a paradigm shift in measure conceptualization and development, using a population and person-centered approach. MAP encourages coordination among stakeholders developing dual eligible beneficiary survey instruments. Additionally, MAP identifies 11 social risk factors that underscore the complexity of the population and recommends that measures should account for and address these identified factors.

In March 2017, MAP submitted the following reports to HHS:

1. The Measure Applications Partnership (MAP) reviewed measures under consideration for several clinician programs. MAP’s pre-rulemaking recommendations for measures in these programs reflect the MAP Measure Selection Criteria, how well the measures address the identified program goals, and NQF’s prior work in identifying families of measures. During its review of the measures, MAP highlighted a number of topics and issues, such as: (1) the relatively new Merit-based Incentive Payment System (MIPS) aligns all clinician measures into a single program; (2) Medicare Shared Savings Program (MSSP) continues to have strong interest from new and renewing ACOs and demonstrates promising results in both quality improvement and financial savings; (3) High-priority measure development remains an important issue in both MIPS and MSSP. This report, MAP 2017 Considerations for Implementing Measures in Federal Programs: Clinicians, explores those issues in further detail.
   
    
2. In its 2016-2017 pre-rulemaking work, MAP emphasized maximizing the value that measurement brings to healthcare improvement while ensuring a person-centered approach to healthcare delivery. This year MAP also provided guidance on the potential future removal of measures from federal programs to reduce the measurement burden on clinician and providers. In addition, MAP discussed better understanding the impact of measurement as a means of maximizing its value in improving healthcare, assessing how measures perform once implemented, and exploring how best to ensure the use of high-value measures. MAP also emphasized in this report, Maximizing the Value of Measurement: MAP 2017 Guidance, the importance of a person-centered approach to measurement by encouraging shared accountability for a patient’s outcomes, developing patient-reported outcome (PRO) based performance measures, and finding ways to increase the information available about healthcare quality to all consumers. Finally, MAP noted the need to ensure that measures used in accountability programs are fair and accurate.

In February 2017, MAP submitted the following reports to HHS:

1. The Measure Applications Partnership (MAP) reviewed measures under consideration for five setting-specific federal programs addressing post-acute care (PAC) and long-term care (LTC). MAP’s pre-rulemaking recommendations for measures in these programs reflect the MAP Measure Selection Criteria, how well the measures address the identified program goals, and NQF’s prior work in identifying families of measures. In addition, MAP provided feedback on the current measure sets for these programs, as well as one additional PAC/LTC-specific program for which new measures were not considered. During its review of the measures, MAP identified several overarching themes including: (1) implementation of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act and (2) Continued Opportunities to Address Quality. This report, MAP 2017 Considerations for Implementing Measures in Federal Programs - Post-Acute Care and Long-Term Care, explores those issues in further detail.
   
   
2. The Measure Applications Partnership (MAP) Hospital Workgroup reviewed measures under consideration for seven hospital and setting-specific programs. In addition, MAP provided feedback on the current measure sets for these programs, as well as two additional hospital-specific programs for which new measures were not considered. MAP identified several overarching issues: including (1) a need for measures across programs that evaluate the appropriate use of health interventions and testing, including pre-operative testing; (2) recognition that effective care transitions are a pivotal lever for improving healthcare quality and are essential to appropriate follow-up care after hospitalization, and (3) the need for measures based on patient-reported outcomes (PROs). MAP also emphasized that providers may have limited resources for measurement and that the addition of new measures to the programs should be balanced with the removal of measures that may no longer be needed. Measure selection should weigh data collection and reporting burden against potential to improve quality of care and patient outcomes. This report, MAP 2017 Considerations for Implementing Measures in Federal Programs - Hospitals, explores those issues in further detail.
   
   
3. For the 2016-2017 pre-rulemaking cycle, MAP reviewed 74 performance measures under consideration for use in 16 federal healthcare programs (MAP 2016-2017 Final Recommendations to HHS and CMS), covering clinician, hospital, and post-acute/long-term care settings. During the pre-rulemaking review cycle, the federal government looks to MAP, a public-private partnership, to advise on the selection of measures. Over the course of the review process, MAP promotes alignment across HHS programs and with private sector efforts, incorporates measure use and performance information into MAP decision-making, and provides specific recommendations about the best use of available measures and measure gaps. MAP has now completed its sixth pre-rulemaking cycle, culminating in these recommendations. This is the first of five reports. MAP will issues reports which include recommendations on overall measure sets and guidance on measure reduction in federal programs, including strategic guidance and issues that cut across settings.

In August 31, 2016, MAP submitted the following reports to HHS:

1. The 2016 final report, Strengthening the Core Set of Healthcare Quality Measures for Adults Enrolled in Medicaid, is the Measure Applications Partnership’s (MAP’s) fourth set of annual recommendations to the U.S. Department of Health and Human Services for strengthening and revising measures in the Core Set of Healthcare Quality Measures for Adults Enrolled in Medicaid (Adult Core Set). Guided by MAP’s Measure Selection Criteria and feedback from three years of state core set implementation, MAP supports the continued use of all 28 measures in the 2016 Adult Core Set. In addition, MAP proposed the addition of six new measures to the Adult Core Set to help improve behavioral health, preventive care and screening, medication adherence and asthma. Although states are increasingly reporting on standardized measures that can be used to compare and benchmark state performance, MAP identified high priority gap areas that lack adequate metrics for measuring quality improvement, including care coordination and access to primary, specialty, and behavioral healthcare. MAP also discussed several strategic issues related to alignment, care coordination, and linking healthcare with community supports and services. The identified strategic issues and gaps will guide future annual revisions to further strengthen the Adult Core Set.
   
   
2. The 2016 final report, Strengthening the Core Set of Healthcare Quality Measures for Children Enrolled in Medicaid, is the Measure Applications Partnership’s (MAP‘s third set of annual recommendations to the U.S. Department of Health and Human Services for strengthening and revising measures in the Core Set of Health Care Quality Measures for Children Enrolled in Medicaid and CHIP (Child Core Set). MAP supported the continued use of all but two of the 26 measures in the Child Core Set. In addition, MAP proposed five measures for phased addition to the Child Core Set to help improve maternity care, behavioral health, and care for individuals with sickle cell disease. Although states are increasingly reporting on standardized measures that can be used to compare and benchmark state performance, MAP identified high priority gap areas that lack adequate metrics for measuring quality improvement, including care coordination, adolescent transition to adult-focused healthcare, and care integration. MAP identified several strategic issues related to alignment, care coordination, and linking healthcare with community supports and services.The identified strategic issues and gaps will guide future annual revisions to further strengthen the Child Core Set.
   
   
3. The 2016 final report, Promoting Community Connections through Quality Measurement for the Dual Eligible Beneficiary Population, is the Measure Applications Partnership’s (MAP’s) latest set of recommendations to the U.S. Department of Health and Human Services (HHS) for performance measures that can improve healthcare services and value for individuals eligible for both Medicare and Medicaid. These beneficiaries are some of the most vulnerable individuals accessing the healthcare system and supportive services, often experiencing disabling disease and complex social circumstances with limited resources. MAP supports the removal of six measures from the Dual Eligible Beneficiaries Family of Measures and shares feedback from stakeholders about priority areas for measurement development, including measures that address the growing role of community supports and services in serving dual eligible beneficiaries. MAP also discusses the need for measures that reflect the multiple complex and interrelated clinical and nonclinical needs of dual eligible beneficiaries.

On March 15, 2016, MAP submitted the following reports to HHS:

1. When deliberating on specific measures during this year’s pre-rulemaking process, the Measure Applications Partnership (MAP) identified in the Cross-Cutting Challenges Facing Measurement: MAP 2016 Guidance - Final Report, broad measurement issues. This includes the importance of attributing measurement results to the appropriate accountable entity and encouraging shared accountability for patient outcomes, the need to reduce healthcare disparities and for the relevant NQF standing committees to review measures that are proposed for selection in programs to determine if sociodemographic adjustment is appropriate, and the need to develop processes to maintain its recommendations. Additionally, MAP used the five-year mark of its establishment to reflect on the changing landscape of performance measurement and federal quality initiatives to identify areas for continued enhancements to the pre-rulemaking process. MAP identified several key changes in the measures under consideration by CMS including: an increasing number of measures early in development and an increase in the number of outcome measures considered.  
   
   
   
2. The Measure Applications Partnership (MAP) reviewed measures under consideration for several clinician programs. MAP’s pre-rulemaking recommendations for measures in these programs reflect the MAP Measure Selection Criteria, how well the measures address the identified program goals, and NQF’s prior work in identifying families of measures. During its review of the measures, MAP identified several overarching issues for clinician programs such as: (1) the new Merit-based Incentive Payment System (MIPS) aligns all clinician measures into a single program; (2) further alignment of clinician measures with ACOs/APMs and hospital/facility measures is warranted; (3) public reporting of clinician measures on Physician Compare is ramping up and (4) measure gaps in both MIPS and MSSP remain. This report, MAP 2016 Considerations for Implementing Measures in Federal Programs - Clinicians, explores those issues in further detail.

In February 2016, MAP submitted the following reports to HHS:

1. For the 2015-2016 pre-rulemaking cycle, MAP received from HHS a list of 141 measures under consideration for use in 16 federal programs (MAP 2016 Final Recommendations to HHS and CMS), covering clinician, hospital, and post-acute/long-term care settings. During the pre-rulemaking review cycle, the federal government looks to MAP, a public-private partnership, to advise on the selection of measures. Over the course of the review process, MAP promotes alignment across HHS programs and with private sector efforts, incorporates measure use and performance information into MAP decision-making, and provides specific recommendations about the best use of available measures and measure gaps. MAP has now completed its fifth pre-rulemaking cycle, culminating in these recommendations. This is the first of three deliverables, and MAP will later release strategic guidance on measurement in different federal health programs, as well as analysis on issues that cut across federal programs or public and private programs.
   
   
2. The Measure Applications Partnership (MAP) reviewed measures under consideration for eight hospital and setting-specific programs. MAP’s pre-rulemaking recommendations for measures in these programs reflect the MAP Measure Selection Criteria, how well the measures address the identified program goals, and the potential impact of a measure on the program measure set and on health and healthcare. Through the discussion of the individual measures across the eight programs, MAP identified several overarching issues. These overarching issues include: (1) measurement to improve quality across the patient-focused episode of care, (2) engaging the patients and their families as partners in care delivery, and (3) driving improvement for all. These themes are explored in more detail in the report, MAP 2016 Considerations for Implementing Measures in Federal Programs - Hospitals.
   
   
3. The Measure Applications Partnership (MAP) reviewed measures under consideration for six setting-specific federal programs addressing post-acute care (PAC) and long-term care (LTC). MAP’s pre-rulemaking recommendations for measures in these programs reflect the MAP Measure Selection Criteria, how well the measures address the identified program goals, and NQF’s prior work in identifying families of measures. MAP also drew upon its Coordination Strategy for Post-Acute Care and Long-Term Care Performance Measurement as a guide to inform pre-rulemaking review of measures for the PAC/LTC programs. During its review of the measures, MAP identified several overarching themes including: (1) implementation of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act and (2) shared accountability across the care continuum. This report, MAP 2016 Considerations for Implementing Measures in Federal Programs - Post-Acute Care and Long-Term Care, explores those issues in further detail.

On August 31, 2015, MAP submitted the following report to HHS:

1. This 2015 Final Report, Advancing Person-Centered Care for Dual Eligible Beneficiaries through Performance Measurement, from the Measure Applications Partnership (MAP) presents multi-stakeholder recommendations for quality measurement in the Medicare-Medicaid dual eligible beneficiary population. These beneficiaries are some of the most vulnerable individuals accessing the healthcare system and supportive services, often experiencing disabling disease and complex social circumstances with limited resources. Quality measurement is an essential catalyst to stimulate needed healthcare improvements and more value-driven use of services for the population. MAP builds upon its previous work in this report by updating its list of the best available measures for dual eligible beneficiaries. MAP also summarizes the results of measure alignment and focused feedback efforts, and describes specialized models of care designed to meet individuals’ complex medical and social needs that promote a more person- and family-centered system.

On August 31, 2015, MAP Task Forces completed the following reports:

1. This final report contains MAP’s recommendations to HHS for strengthening and revising measures in the Core Set of Health Care Quality Measures for Adults Enrolled in Medicaid. Guided by MAP’s Measure Selection Criteria and feedback from two years of state implementation, MAP supported all except one of the measures in the current Adult Core Set for continued use in the program. MAP recommended nine measures for phased addition. MAP identified several strategic issues and also included a list of high-priority measure gaps as a starting point for future discussions. The identified strategic issues and gaps will guide annual revisions to further strengthen the Adult Core Set.
   
   
2. This final report contains MAP’s recommendations to HHS for strengthening and revising measures in the Core Set of Health Care Quality Measures for Children Enrolled in Medicaid. MAP supported all of the current measures for continued use and recommended up to six measures for phased addition to the Child Core Set. Adoption of the six measures MAP supported would strengthen the measure set by promoting attention to high-priority quality issues, including maternity care and behavioral health. MAP also documented high priority measure gaps to communicate its vision for future measurement to the developer community. In addition, MAP identified several strategic issues related to the Child Core Set and its relationship to the Core Set of Health Care Quality Measures for Adults Enrolled in Medicaid (Adult Core Set). These include alignment of measures across programs and enabling quality improvement activities within states.

In March 2015, MAP submitted the following reports to HHS:

1. When deliberating on specific measures during this year’s Measure Applications Partnership (MAP) pre-rulemaking process, the MAP identified broad measurement issues, including measurement gaps, implementation challenges, and unintended consequences. The Cross-Cutting Challenges Facing Measurement: MAP 2015 Guidance - Final Report outlines several cross-cutting themes across federal programs MAP examined this year, along with issues that were identified for the cross-cutting Medicare Shared Savings Program.
   
   
2. The Measure Applications Partnership (MAP) reviewed measures under consideration for several clinician programs. MAP’s pre-rulemaking recommendations for measures in these programs reflect the MAP Measure Selection Criteria, how well the measures address the identified program goals, and NQF’s prior work in identifying families of measures. During its review of the measures, MAP identified several overarching issues for clinician programs such as: (1) including more high-value measures in federal programs; (2) a greater focus on parsimony and alignment of measures in programs to reduce burden; and (3) the need of incentives for more meaningful measurement. The MAP 2015 Considerations for Implementing Measures in Federal Programs: Clinicians - Final Report explores those issues in further detail.
   
   
3. External from the annual Measure Applications Partnership (MAP) pre-rulemaking cycle process, the federal government sought input from the MAP on additional measures under consideration under an expedited timeline. Considered an “off-cycle review”, MAP convened in early- to mid-February to provide recommendations to the Department of Health and Human Services (HHS) on a selection of performance measures to meet requirements of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. This report, MAP Off-Cycle Deliberations 2015 - Final Report, explores those recommendations in further detail.

In February 2015, MAP submitted the following reports to HHS:

1. MAP reviewed measures under consideration for nine hospital and setting-specific programs. MAP’s pre-rulemaking recommendations for measures in these programs reflect the MAP Measure Selection Criteria, how well the measures address the identified program goals, and NQF’s prior work in identifying families of measures. During its review of the measures, MAP identified several overarching issues including: (1) the need for a parsimonious set of high value measures, and (2) the need to increase alignment across programs by focusing on comparable performance across settings and data types. This report, MAP Hospital Programmatic Deliverable - Final Report, explores those issues in further detail.
   
   
2. MAP reviewed measures under consideration for five setting-specific federal programs addressing post-acute care (PAC) and long-term care (LTC). MAP’s pre-rulemaking recommendations for measures in these programs reflect the MAP Measure Selection Criteria, how well the measures address the identified program goals, and NQF’s prior work in identifying families of measures. During its review of the measures, MAP identified several overarching issues including: (1) emphasizing harmonization of measures to promote patient-centered care across PAC/LTC programs, (2) coordinating efforts between patient assessment instruments used in PAC/LTC settings to maintain competencies and quality of data, and (3) aligning performance measurement across PAC/LTC settings as well as with other settings to ensure comparability of performance and to facilitate information exchange. This report, MAP PAC-LTC Programmatic Deliverable - Final Report, explores those issues in further detail.

In January 2015, MAP submitted the following report to HHS:

1. For the 2014-2015 pre-rulemaking cycle, MAP received from HHS a list of approximately 200 measures under consideration for use in 20 federal programs (MAP 2015 Final Recommendations to HHS and CMS) , covering clinician, hospital, and post-acute/long-term care settings. During the pre-rulemaking review cycle, the federal government looks to MAP, a public-private partnership, to advise on the selection of measures. Over the course of the review process, MAP promotes alignment across HHS programs and with private sector efforts, incorporates measure use and performance information into MAP decision-making, and provides specific recommendations about the best use of available measures and measure gaps. MAP has now completed its fourth pre-rulemaking cycle, culminating in these recommendations. This is the first of three deliverables, and MAP will later release strategic guidance on measurement in different federal health programs, as well as analysis on issues that cut across federal programs or public and private programs.

On November 14, 2014, MAP Task Forces completed the following report:

1. This final report contains MAP’s recommendations to HHS for strengthening and revising measures in the Core Set of Health Care Quality Measures for Children Enrolled in Medicaid and CHIP (Child Core Set). MAP supports all but one of the measures in the current Child Core Set for continued use in the program and six measures for phased addition to the Child Core Set. This expedited review focused on addressing high-priority measure gaps as well as cross-cutting and strategic issues. These strategic issues, as well as any newly-endorsed measures in critical gap areas, will be considered further during the MAP’s next review of the Child Core Set, scheduled to be completed by August 2015.

On August 29, 2014, MAP Task Forces completed the following report:

1. This final report contains MAP’s recommendations to HHS for strengthening and revising measures in the Core Set of Healthcare Quality Measures for Adults Enrolled in Medicaid (Adult Core Set). To conduct this review, MAP applied its standard measure selection criteria and considered states’ feedback from the first year of implementation to carefully evaluate and identify opportunities to improve the Adult Core Set. MAP supports the continued use of 22 measures, conditionally supports the continued use of 3 measures, and suggests the removal of 1 measure. MAP also recommends three measures for phased addition. The program measure set will continue to evolve in response to changing federal, state, and stakeholder needs and its maintenance should be considered a long-term strategic process.

On August 29, 2014, MAP submitted the following report to HHS:

1. This 2014 Input on Quality Measures for Dual Eligible Beneficiaries final report from the Measure Applications Partnership (MAP) presents multistakeholder recommendations for quality measurement in the Medicare-Medicaid dual eligible beneficiary population. Measuring and improving the quality of care and services offers an opportunity to address the needs of these beneficiaries, their families, and their caregivers who often experience complex health and social circumstances. This report builds on prior work by updating the Family of Measures for Dual Eligible Beneficiaries and identifying persistent measure gaps. MAP also provides recommendations for the continued exploration of performance measurement of health-related quality of life for this and other vulnerable populations. Looking to the future, MAP describes an initial approach to gathering stakeholder experience in applying performance measures in Medicare and Medicaid programs.

On July 1, 2014, MAP Task Forces completed the following report:

1. This final report from MAP identifies families of measures—sets of related available measures and measure gaps that span programs, care settings, levels of analysis, and populations-related to three National Quality Strategy priorities: Affordability, Person- and Family-Centered Care, and Population Health. The measures selected for each family were reviewed by task forces and the MAP Coordinating Committee and outlined in this report. Additionally, this report builds on prior analyses of gaps in the nation’s measurement capabilities, and it articulates a clear vision on where measurement needs to be and outlines specific opportunities where progress can be made.

On February 28, 2014, MAP submitted the following report to HHS:

1. The 2014 Interim Report from the MAP Dual Eligible Beneficiaries Workgroup is the latest in a series to describe quality measurement in the Medicare-Medicaid dual eligible beneficiary population. One of two major topics of the interim report is the creation and use of a family of measures for dual eligible beneficiaries to achieve alignment in measure use across a range of programs.

In January 2014, MAP submitted the following reports to HHS:

1. MAP Pre-Rulemaking Report: 2014 Recommendations on Measures for More than 20 Federal Programs includes a review of more than 234 measures submitted by HHS.
    
2. MAP Input on the Quality Rating System for Qualified Health Plans in the Health Insurance Marketplaces provides recommendations to HHS on the performance measures proposed for use in the initial implementation of the Quality Rating System. The purpose of the Quality Rating System is two-fold, enabling consumer choice and supporting regulatory oversight. MAP’s report focuses on identifying performance measures that will best inform consumer selection of health plans in the marketplaces.

On October 15, 2013, MAP submitted the following report to HHS:

1. MAP Expedited Review of the Initial Core Set of Measures for Medicaid-Eligible Adults offers a mix of general and measure-specific recommendations to improve the accuracy, breadth, and feasibility of reporting the Medicaid Adult Core Set. This report also includes information that was provided to MAP as background to inform its review of the Core Set, specifically an overview of the population of adults enrolled in Medicaid and the purpose and history of the Adult Medicaid Quality Reporting Program.

On February 1, 2013, MAP submitted the following report to HHS:

1. MAP Pre-Rulemaking Report: 2013 Recommendations on Measures Under Consideration by HHS includes a review of more than 500 measures submitted by HHS. The measures apply to nearly 20 federal programs.

October 1, 2012, MAP submitted two reports to HHS:

1. MAP Strategic Plan: 2012 - 2015 outlines a three-year strategic plan for MAP. The plan offers actionable steps to make MAP's work more useful to a variety of stakeholders across public and private sectors, and representative of a true partnership in pursuit of national improvement priorities.
    
2. MAP Families of Measures: Safety, Care Coordination, Cardiovascular Conditions, Diabetes report presents a new way of thinking about and organizing measures for use — called families of measures. The families of measures will serve as a starting place and guide for MAP's recommendations to HHS about the best available measures for specific programs, that are also related across multiple care settings. This report focuses specifically on measures for safety, care coordination, cardiovascular conditions, and diabetes. 

June 1, 2012, MAP submitted four reports to HHS: 

1. Measuring Healthcare Quality for the Dual Eligible Beneficiary Population: Final Report to HHS is MAP's second report to address a strategic approach to performance measurement in that unique and clinically complex group. The report discusses a core set of available measures, potential modifications to existing measures, gap areas for future measure development, as well as potential applications and alignment opportunities.
    
2. The Performance Measurement Coordination Strategy for Hospice and Palliative Care provides a strategy to enhance alignment with a focus on three key areas: 1) high-leverage measure concepts for hospice and palliative care to promote common goals across programs; 2) measures that can be readily incorporated into hospice and palliative care measurement programs; and 3) a pathway for improving measure application.
    
3. The Performance Measurement Coordination Strategy for PPS-Exempt Cancer Hospitals identifies four major focus areas: 1) priorities for measuring performance in PPS-exempt cancer hospitals; 2) a core set of available measures plus measure development, endorsement, and implementation gaps; 3) data and health information technology (health IT) considerations; and 4) implications for measuring performance in cancer care beyond PPS-exempt cancer hospitals.
    
4. MAP's Approach to the Strategic Plan establishes MAP's goal and outlines tactics for achieving its objectives. The strategic plan approach will inform MAP's Strategic Plan which will be completed in October 2012.

MAP previously submitted a series of five reports to HHS: 

1. The MAP Pre-Rulemaking Report: Input on Measures Under Consideration by HHS for 2012 Rulemaking includes a review of more than 350 measures submitted by HHS in December 2011. The measures apply to nearly 20 federal healthcare programs. 
   •     List of Measures Under Consideration
   •     FAQs  
    
2. The MAP Coordination Strategy for Post-Acute Care and Long-Term Care Performance Measurement report makes recommendations on aligning measurement, promoting common goals for PAC and LTC providers, filling priority measure gaps, and standardizing care planning tools.
    
3. Readmissions and Healthcare-Acquired Conditions Performance Measurement Strategy Across Public and Private Payers presents a coordination strategy for aligning performance measurement with specific recommendations on a national core set of safety measures, data elements, and incentive structures – all approaches to reducing healthcare-acquired conditions and hospital readmissions.
    
4. Coordination Strategy for Clinician Performance Measurement provides recommendations for coordinating clinician performance measurement across federal programs, with focus on alignment of measures and data sources, reducing duplication and burden, identifying characteristics of an ideal measure set, and promoting standardized data elements linked to achieving overall national aims for improved health and healthcare.
    
5. Strategic Approach to Performance Measurement for Dual Eligible Beneficiaries is an interim report outlining a strategic approach to performance measurement for the dual eligible beneficiary population. It presents a vision, guiding principles, high-leverage opportunities for improvement, high-need population subgroups, illustrative measures, and considers issues related to data sources and program alignment. 

As background to MAP's work, NQF sponsored a report from RAND, Payment Reform: Analysis of Models and Performance Measurement Implications