CMS and Joint Commission measures are aligned

The Centers for Medicare & Medicaid Services (CMS)'s final rule on the inpatient prospective payment system requires hospitals to report on the full set of 21 Hospital Quality Alliance measures to get full payment updates, effective for discharges on or after October 1, 2006.

However, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has worked with CMS to standardize the measures so staff won't have to collect data for two different measurement sets, reports Sharon Sprenger, project director of JCAHO's group on core performance measurement.

In 2001, when JCAHO's four initial core measurement areas for hospitals — acute myocardial infarction (AMI), heart failure (HF), pneumonia (PN), and pregnancy and related conditions (PR) — were announced, JCAHO began working with CMS on the AMI, HF, and PN sets that were common to both organizations.

CMS and JCAHO worked together to align the measure specifications for quality improvement organization contracts and JCAHO-accredited hospitals that began collecting these measures for patient discharges beginning July 1, 2002.

"Since November of 2003, CMS and the Joint Commission have worked to precisely and completely align these common measures so that they are identical," says Sprenger. "Where we have common measures, then we have worked to have the exact same specifications."

A single common set of measure specifications documentation, The Specifications Manual for National Hospital Quality Measures, is used by both CMS and JCAHO, with an identical data dictionary, measure information forms, and algorithms. "Since we have common specifications, you only need to collect the data once to meet both the needs of CMS and JCAHO," says Sprenger. "The goal is to minimize data collection efforts for these common measures and focus efforts on the use of data to improve the health care delivery process."

There are other initiatives collecting data on a national level which are currently working to align quality measures, adds Sprenger. "There is certainly work in progress. All of us involved in measure development are very cognizant of the need to standardize where possible," she says.

For example, two organizations might have a measure on a similar topic but with different age groups, such as using 14 or 15 years as the definition for pediatric patients.

"One of first things to do is review measures in use or under development for use, that address similar aspects of quality but have different specifications — and develop a plan to align the specifications," says Sprenger.