Now Available: 2021 Eligible Professionals/Eligible Clinicians and Eligible Hospitals/Critical Access Hospitals Electronic Clinical Quality Measure Flows

The Centers for Medicare & Medicaid Services (CMS) developed and published the 2021 performance/reporting period electronic clinical quality measure (eCQM) flows for eligible professionals/eligible clinicians and eligible hospitals/critical access hospitals to the eCQI Resource Center.

The eCQM flows are designed to assist in interpretation of the eCQM logic and calculation methodology for performance rates. The eCQM flows provide an overview of each of the population criteria components and associated data elements that lead to the inclusion or exclusions into the eCQM’s quality action (numerator).

The eCQM flows supplement eCQM specifications 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)

These flows are intended to be used as an additional resource when implementing eCQMs and should not be used in place of the eCQM specification or for reporting purposes. Specific to the Eligible Hospital/Critical Access Hospital eCQM flows, a “Read Me First” guide is available to assist users as they navigate the flows.   

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