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Seeking Clinical Practices to Participate in CMS Measure Development Testing

January 17, 2018 - 12:16pm

CMS Seeking Practices to Participate in Measure Development Testing Opportunity


The Centers for Medicare & Medicaid Services (CMS) is currently seeking primary care and specialty practices (individual, institutions, and groups) to help test a potential change to an electronic clinical quality measureinfo-icon (eCQMinfo-icon) related to clinician referrals. The measure is entitled Closing the Referral Loop: Receipt of Specialist Report (CMS50v5).


Interested practices should be reporting this eCQM under the Merit-Based Incentive Payment System (MIPS) or another CMS quality improvement initiative. Data elements should be documented in structured fields of the electronic health record (EHRinfo-icon) or electronic medical record (EMR), and practices should be able to extract patient-level information about data elements. Under the current measure specificationinfo-icon, the denominatorinfo-icon includes the first referral for each patient who was referred to other clinicians during the measurement period. Under the proposed revisions to the measure, the denominator includes all referrals during the measurement period.


The testing activities will involve practice staff—both clinicians and, if applicable, practice managers—speaking with a project team from Mathematica Policy Research, a CMS contractor, about the practices’ workflows and the data elements they capture in their EHRsinfo-icon. Practices will be asked to submit an extract of de-identified patient-level data from the EHR, including all of the data elements required to calculate the current and proposed revised versions of the measure. Additionally, practices will be asked to work with the Mathematica project team who will abstract data from a sample of charts to verify the accuracy of the data elements. The de- identified patient-level data will be shared with Mathematica for analysis. Practices will receive feedback from Mathematica about their data, including rates of referrals and the proportioninfo-icon of referrals with follow-up information returned to the referring provider by the specialist. Honoraria will range from $2,000-$4,000, depending on practices’ level of testing participation.  None of the testing activities will involve an audit of the practices’ performance scores reported to CMS quality reporting programs.


If you are interested in assisting with this activity, please contact Shari Glickman at and Omoniyi Adekanmbi at OAdekanmbi@mathematica-

Last Updated: January 17, 2018