Updated eCQM Specifications and eCQM Materials for 2021 Reporting Now Available

The Centers for Medicare & Medicaid Services (CMS) has posted the electronic clinical quality measure (eCQM) specifications for the 2021 reporting period for Eligible Hospitals and Critical Access Hospitals, and the 2021 performance period for Eligible Professionals and Eligible Clinicians. CMS updates the specifications annually to align with current clinical guidelines and code systems so they remain relevant and actionable within the clinical care setting. These updated eCQMs are to be used to electronically report 2021 clinical quality measure data for CMS quality reporting programs. Measures will not be eligible for 2021 reporting unless and until they are proposed and finalized through notice-and-comment rulemaking for each applicable program.

CMS has updated eCQMs for potential inclusion in the following programs:

Hospital Inpatient Quality Reporting (IQR) Program
Medicare and Medicaid Promoting Interoperability Programs
Quality Payment Program (QPP): The Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs)
APM: Comprehensive Primary Care Plus (CPC+)
APM: Primary Care First (PCF)

Where to Find the Updated eCQM Specifications and Materials

The updated eCQM specifications are available on the eCQI Resource Center for Eligible Hospitals and Critical Access Hospitals and Eligible Professionals and Eligible Clinicians under the 2021 Reporting/Performance Year. Other eCQM resources, including the Guide for Reading eCQMs, eCQM Logic and Implementation Guidance, tables of eCQMs, and technical release notes, are also available at the same locations. The Guide to Reading eCQMs and eCQM Logic and Implementation Guidance have been updated based on end user feedback and CMS continues to update these guides to assist stakeholders in understanding and implementing eCQMs.

Where to Find the 2021 eCQM Value Sets, Direct Reference Codes, and Terminology

The 2021 reporting/performance period eCQM value sets are available through the National Library of Medicine’s Value Set Authority Center (VSAC). The value sets are available as a complete set, as well as value sets per eCQM. The direct reference codes specified within the eCQM HQMF files are also available in a separate file for download on the VSAC Downloadable Resources page.

Pre-Rulemaking Information

The eCQI Resource Center includes information about CMS pre-rulemaking eCQMs. CMS pre-rulemaking eCQMs include measures that are developed, but specifications are not finalized for reporting in a CMS program. At this time, there are two pre-rulemaking eCQMs for Eligible Professionals and Eligible Clinicians and no pre-rulemaking eCQMs for Eligible Hospitals and Critical Access Hospitals. These measures will not be eligible for CMS quality reporting until they are proposed and finalized through notice-and-comment rulemaking for each applicable program. Please visit the pre-rulemaking eCQM pages for Eligible Hospitals and Critical Access Hospitals and for Eligible Professionals and Eligible Clinicians to learn more. The pre-rulemaking eCQM value sets for use in the pre-rulemaking eCQMs are available through the VSAC.

Hospital Hybrid Measures Information

The eCQI Resource Center includes information about CMS hybrid measures for eligible hospitals and critical access hospitals. A hybrid measure is a quality measure that uses both claims data and clinical data from electronic health records (EHRs) for calculating the measure. Please visit the new hybrid measures page on the eCQI Resource Center to learn more. The hybrid measure value sets for use in the hybrid measures are available through the VSAC.

Quality Data Model Update

CMS has published a guidance update for the Quality Data Model (QDM) version 5.5. The referenced document clarifies some of the definitions and fixes minor errata noted in the document initially published to the eCQI Resource Center in August 2019.

For More Information

To find out more about eCQMs, visit the eCQI Resource Center.

Visit the eCQM Data Element Repository which is a searchable module in the eCQI Resource Center that provides all the data elements associated with eCQMs in CMS quality reporting programs, as well as the definitions for each data element. This information is intended to improve clarity for those implementing eCQMs.

For Questions Regarding eCQMs

To report questions or comments on the eCQM specifications, visit the eCQM Issue Tracker.

Note that an ONC Project Tracking System (Jira) account is required to ask a question or comment.

Daily COVID-19 News Alert

Here is a summary of recent Centers for Medicare & Medicaid Services (CMS) actions taken in response to coronavirus disease 2019 (COVID-19), as part of the ongoing White House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, click here www.coronavirus.gov. For information specific to CMS, please visit the CMS News Room and Current Emergencies Website. CMS updates these resources on an ongoing basis throughout the day; the information below is current as of May 7, 2020 at 11:00 a.m. ET.

New Guidance Available on Requirements for Notification of Confirmed and Suspected COVID-19 Cases Among Residents and Staff in Nursing Homes

Nursing homes are now required to report the first week of COVID-19 data to the Centers for Disease Control and Prevention (CDC) beginning May 8 but no later than May 17. For the first time, all 15,000 nursing homes will be reporting this data directly to the CDC through its reporting tool. This reporting requirement is the first action of its kind in the agency’s history. On April 19, CMS announced the agency would be requiring facilities to report COVID-19 information to the CDC and to families. Within three weeks of that announcement, on April 30, CMS issued an Interim Final Rule with Comment Period with the new regulatory requirements. As nursing homes report this data to the CDC, we will be taking swift action and publicly posting this information so all Americans have access to accurate and timely information on COVID-19 in nursing homes.

CMS has a longstanding requirement for nursing homes to report cases of communicable diseases, such as COVID-19, to the appropriate state or local health department. This new requirement not only helps health departments intervene when needed, but serves to provide awareness to the public (e.g., families), and surveillance for public health agencies and the CDC. The importance of ongoing transparency and information sharing has proven to be one of the keys to the battle against this pandemic. Building upon the successes of the Trump Administration prior to COVID-19, CMS has strongly supported transparency, such as the work done over the past several years to improve public access and understanding of nursing home inspection reports and expand the information available to consumers on Nursing Home Compare. The agency remains committed to greater transparency, and plans to publicly release new data by the end of May. CMS will never stop working to give patients, residents, and families the clearest and most accurate information possible.

Guidance and Frequently Asked Questions

CMS Releases Additional Medicaid & CHIP COVID-19 FAQs for State Medicaid and CHIP Agencies

CMS released additional frequently asked questions (FAQs) to aid state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their response to the coronavirus disease 2019 (COVID-19) pandemic. The new FAQs cover a variety of Medicaid and CHIP topics, including emergency preparedness and response, benefit, financing, eligibility and enrollment flexibilities, information technology, and data reporting. CMS is committed to providing our state partners the resources they need during this public health emergency.

New Frequently Asked Questions

Comprehensive Medicaid COVID-19 FAQs

CMS Gives States Additional Flexibility to Address Coronavirus Pandemic

CMS has approved over 155 requests for state relief in response to the COVID-19 pandemic, including recent approvals for Arizona, Arkansas, Colorado, Iowa, Hawaii, Maryland, New Mexico, New York, Pennsylvania, the U.S. Virgin Islands, and Washington. These approvals help to ensure that states have the tools they need to combat COVID-19 through a wide variety of waivers, amendments, and Medicaid state plan flexibilities, including support for programs that care for the elderly and people with disabilities. CMS developed a toolkit to expedite the application and review of each request and has approved these requests in record time. These approved flexibilities support President Trump’s commitment to a COVID-19 response that is locally executed, state managed, and federally supported.

Section 1135 Waivers

Section 1115(a) Waivers

1915(c) Waiver Appendix K Amendments

Medicaid State Plan Amendments

CHIP State Plan Amendments