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Glossary

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Patient-reported outcome

A patient-reported outcome (PRO) is any report of the status of a patient’s health condition, health behavior, or experience with healthcare that comes directly from the patient, without interpretation of the patient’s response by a clinician or anyone else. This definition reflects the key domains of

  • Health-related quality of life (including functional status)
  • Symptoms and symptom burden (e.g., pain, fatigue)
  • Experience with care
  • Health behaviors (e.g., smoking, diet, exercise)
Patient-reported outcome measure

A patient-reported outcome measure (PROM) is an instrument, scale, or single-item measure used to assess the patient-reported outcome (PRO) concept as perceived by the patient, obtained by directly asking the patient to self-report.

Patient-reported outcome-based performance measure

A patient-reported outcome-based performance measure (PRO-PM) is a performance measure that is based on patient-reported outcome measure (PROM) data aggregated for an accountable healthcare entity.

Process measure

A process measure is a measure that focuses on a sequence of actions or steps that should be followed to provide high quality evidence-based care. There should be a scientific basis for believing that the process, when executed well, will increase the probability of achieving a desired outcome.

Proportion

A proportion is a score derived by dividing the number of cases that meet a criterion for quality (the numerator) by the number of eligible cases within a given time frame (the denominator) where the numerator cases are a subset of the denominator cases (for example, percentage of eligible women with a mammogram performed in the last year).

Provider - Hospital

A Provider-Hospital is a medical facility that reports eCQMs and Improving Interoperability Program data through the CMS QualityNet Secure Portal. Provider - Hospital includes: Medicaid-eligible hospitals, Medicare-eligible hospitals, dual-eligible hospitals (both Medicare and Medicaid), and critical access hospitals (CAHs).

Provider - Professional/Clinician

A  Provider - Professional/Clinician is a clinician or health care professional who is eligible to participate in the Quality Payment Program through the Merit-based Incentive Payment System (MIPS), Medicaid Promoting Interoperability Program, and similar participants of other CMS programs using eCQMs for quality reporting such as Alternative Payment Models (APMs).