The National Quality Forum's Measure Applications Partnership pushed back against the CMS on some of the agency's tactics to remove quality measures as part of its 2018 guidance to HHS.
The CMS has been removing measures it says are burdensome on clinicians, favoring outcome measures rather than process measures for quality tracking. That has sparked concern from the partnership in three separate reports released Wednesday.
The NQF coalition said that while it supports the CMS' effort to alleviate clinicians' reporting burden, it's important for the agency to find a balance between the value of a measure and the effort clinicians need to take to report it. The coalition noted that "some of the most meaningful measures may have a high measurement burden."
"There may be negative unintended consequences if low burden measures are prioritized over meaningful measures with a higher burden," the coalition wrote.
Additionally, the partnership appeared to take issue with the CMS' preference for outcome measures over process measures. As part of the Meaningful Measures initiative announced last October, the CMS said it "aims to focus on outcome-based measures going forward, as opposed to trying to micromanage processes."
But both types of measurements are important, the NQF coalition said, and process measures with solid evidence bases should be used.
The group also endorsed using composite measures that provide a more comprehensive view of how care was received.
The NQF coalition reports also cautioned the CMS not to dismiss measures due to lack of performance variation between providers. They warned that the removal of such measures "could lead to negative unintended consequences."
The coalition noted the importance of including patients and consumers in the development and selection process so the measures are valuable to them.