Performance on Electronic Clinical Quality Measures in the Comprehensive Primary Care Initiative

Area of Science:

• Health Services Research
• Health Informatics
• Healthcare Quality Improvement

Background:

• Electronic clinical quality measures (eCQMs) offer potential for accurate health data capture from electronic health records.
• Despite their promise, eCQMs have seen limited integration into healthcare payment models.
• The Centers for Medicare & Medicaid Services (CMS) explored eCQM use within the Comprehensive Primary Care initiative.

Purpose of the Study:

• To evaluate the performance of practices participating in a CMS initiative that utilized eCQMs for shared savings.
• To establish benchmarks for 11 specific eCQMs and compare initiative practices against these benchmarks.
• To assess the feasibility of using eCQMs as a basis for healthcare payment incentives.

Main Methods:

• Development of performance benchmarks for 11 selected eCQMs.
• Comparison of eCQM performance between practices in the Comprehensive Primary Care initiative and benchmark practices.
• Analysis of performance trends from 2015 to 2016 for initiative practices.

Main Results:

• Initiative practices surpassed benchmark performance on 8 measures in 2015 and 9 measures in 2016.
• Significant improvements in performance were observed for initiative practices across 7 measures between 2015 and 2016.
• For 3 measures, initiative practices demonstrated greater improvement over a 2-year period compared to benchmark practices.

Conclusions:

• Electronic clinical quality measures (eCQMs) are viable for use in healthcare payment systems.
• The Comprehensive Primary Care initiative demonstrated the effectiveness of eCQMs in driving quality improvement and supporting shared savings.
• eCQMs can facilitate accurate and timely performance measurement for value-based care models.