CORE MEASURE SETS

The CQMC defines a core measure set as a parsimonious group of scientifically sound measures that efficiently promote a patient-centered assessment of quality and should be prioritized for adoption in value-based purchasing and Alternate Payment Models (APMs). 

The CQMC has developed and released core sets of quality measures that could be implemented across both commercial and government payers.

CQMC Workgroups have convened on a yearly basis to update the existing ten core sets. Core set maintenance involves members with different perspectives engaging in meaningful dialogue and coming to consensus around sets of measures that reflect the best opportunities to improve care and outcomes. CQMC Workgroups review new measures that could be added to the core sets to address high-priority areas. Workgroups also review measures in the existing sets and remove measures if necessary – for example, if they no longer have an opportunity for improvement, no longer align with clinical guidelines, or have implementation challenges. The Workgroups also discuss measurement gaps and adoption successes and challenges. For more detailed information on the Workgroups’ discussion, view the workgroup meeting summaries.

The updated core sets have been approved by the Steering Committee and finalized by the full Collaborative. The documents below reflect the most recent versions of the core sets (last updated 2023):

• Accountable Care Organizations/Patient Centered Medical Homes/Primary Care (PDF)
• Behavioral Health (PDF) NEW!
• Cardiology (PDF) NEW!
• Gastroenterology (PDF) NEW!
• HIV & Hepatitis C (PDF) NEW!
• Medical Oncology (PDF)
• Neurology (PDF)
• Obstetrics & Gynecology (PDF) NEW!
• Orthopedics (PDF)
• Pediatrics (PDF) NEW!

GUIDING PRINCIPLES AND DOCUMENTS

The CQMC relies on Workgroups to select measures for the core sets, guide the development and refinement of materials used to update the core sets, and prioritize gaps and areas for future core set development. Workgroup discussion and activities are guided by the following principles:

• All Workgroups use the same set of Principles for Core Set Measure Selection (PDF) to guide the development and updating of the core sets (updated 2021).
• The CQMC recognizes additional clinical areas or cross-cutting topics could benefit from the creation of core measure sets and has developed potential Approaches to Future Core Set Prioritization (PDF) (updated 2020).
• The CQMC has also identified measurement gaps across the core sets, including both areas where measures do not exist and areas where measures are not ready or are insufficient. These are described in the Analysis of Measurement Gap Areas and Measure Alignment report (PDF) (updated 2022).

CQMC REPORTS

In addition to developing core sets, CQMC Workgroups have also discussed high-priority topic areas related to quality measurement, providing guidance and recommendations for future activities. Recent reports from the CQMC include:

• The CQMC Health Equity Final Report (PDF) proposes methodologies for identifying disparities-sensitive measures within the CQMC core sets and identifying and classifying existing measures and measure concepts that promote health equity and could be used by payers in value-based contracts. The report also recommends strategies for prioritizing disparities-sensitive measures, as well as outlining future opportunities for the CQMC to address health equity measurement.
• The CQMC Digital Measurement Report (PDF) outlines the current landscape for digital quality measure (dQM) implementation, including the business case for the CQMC to promote dQM use to advance alignment and overcome current barriers to dQM implementation. The report illustrates a future state data flow built on the Fast Healthcare Interoperability Resources (FHIR) standard and notes relevant stakeholders at each step, as well as outlines future activities for the CQMC to promote the transition to digital measurement.
• The CQMC: Aligning Approaches to Measure Models report (PDF) addresses opportunities for measure model alignment. Measure model alignment goes beyond aligning the quality measures used in programs and encompasses other technical elements such as collection, transmission, standardization, aggregation, and dissemination of data to support scaled core set adoption and implementation. This report summarizes promising practices from regional collaborative models that allow diverse stakeholders to align on elements of the quality measurement process, as well as identifying barriers and solutions that may enable greater model alignment on a national level.
• The CQMC Implementation Guide (PDF) provides strategies and actions for stakeholders seeking to implement or evolve value-based payment (VBP) programs, focusing on four elements of successful implementation: leadership and planning, stakeholder engagement and partnership, measure alignment, and data and quality improvement support. The 2021 update has been supplemented with additional content from Workgroup discussion and key informant interviews. This includes key insights and promising practices shared by regional quality collaboratives, purchasers, and health plans, as well as approaches for using data to identify and address disparities.