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Federal Register / Vol. 86, No. 164 / Friday, August 27, 2021 / Notices
Appendix H: Medicare Measure Gaps Identified by NQFs Measure Applications Partnership MAP Clinician Worqroup Within the Merlt"Based Incentive Payment System MIPS measure set, MAP Identified several gaps, speclflcally In the areas of primary care, access, continuity, comprehension, and care coordination. MAP
also suggested that CMS consider adding measures that d.etermlne whether a course of therapy Is Indeed the best for the patient to optimize reduc;tlons In cost and harm. MAP also emphasized measures of diagnostic accuracy and primary care PROMs.
MAP Identified several measure gaps within the Shared Savings Program: diagnostic efficiency, measures of cultural change, and addltlonal measures of care coordination and handoffs using eCQMs.
MAP discussed measure gaps associated with the Medicare Part C and D Star Ratings and suggested that C:MS add measures of access to .provider networks, PROMs related to functional status, and care coordination within care transitions. MAP expressed cOhcem that the medication adherenc;e measures do not capture rational non-adherence and patient.preference, and also. 11uggested the removal of older process measures, such as diabetes screening, In favor of measures that beneficiaries might find more useful when selecting a plan, such as out-of-pocket cost. MAP also suggested the Inclusion oftelehealth Into existing measures.
MAP Hospital Workaroup In consideration of measure gaps, MAP noted that all of the End-Stage Renal Disease ESRD Quality Improvement Program QIP patient experience measures are composites, and MAP suggested that InCenter Hemodlalysls ICH CAHPS questlbns could be broken out and reported separately. MAP also called on CMS to consider how to Include more specific patient safety measures beyond the generic question Included In CAHPS as well as functional status and quality of life measures, especially given the slated changes In payment policy related to dialysis coverage through Medicare Advanta,e.
MAP suggested the Hospital Inpatient Quality Reporting IQR program would benefit from additional care transitions measures as well as enhanced measures of preventable healthcare harm, such as the PSI
90 composite NQF 0531 . MAP encouraged the development of Medicare spending per beneficiary measures for conditions that align with CMS mortality and readmission measures. MAP also stressed that the program would benefit from additional patient safety measures as well as measures on engagement of patients and famllles and transfer of Information across care settings.
MAP suggested that CMS Identify measurement priorities for patient populations within units for Inpatient psychiatric facmttes, speclflcally geriatric units for Inpatient Psychiatric Faclllty Quallty Reporting IPFQR.

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MAP noted a gap In measures within Prospective Payment System Exempt cancer Hospital Quality Reporting PCHQR regarding PROs for functional outcomes and quality of life, access to care, and survival. It was also noted that measures are needed to. ensure smooth transitions between care settings, especially hospice. MAP also noted the need for measures that encourage the move from standardized approaches within cancer care to Increased adoption of personalized medicine and pharmacogenomlc testing. MAP encouraged CMS to continue partnerships with existing cancer registries to. gather data for future measurement.