Meaningful Measures Frequently Asked Questions & Tools

Click each question for more information about Meaningful Measures. 

What are Meaningful Measures?

The Meaningful Measures Initiative is our plan to find the highest priorities for quality measurement and improvement. CMS wants to look at only the most important issues that influence high-quality care and improve individual health outcomes. 

What have stakeholders told us about Meaningful Measures?

Stakeholders have shared their support for strong quality measurement to move toward value-based care. They’ve also said measures can burden clinicians and hospitals when they must manually abstract data to submit to CMS and others (e.g., commercial insurers)since it takes time away from patient care.

CMS has also heard that because we implemented many quality measures across care settings, it’s hard to understand how these measures relate to each other and to CMS goals. Specifically, we heard this feedback from stakeholders participating in the Measure Applications Partnership (MAP), convened by the National Quality Forum, and the Health Care Payment Learning and Action Network.

Based on this feedback, CMS is promoting the development of digital measures to ease the manual abstraction burden of data collection and reporting. We’re also working with commercial insurers though the Core Quality Measures Collaborative and other federal agencies, including the Department of Defense and the Department of Veterans Affairs, to align and harmonize measures. We’re also still working to reduce the number of measures using tools like the Cascade of Measures.

What does the Meaningful Measures Initiative do?

The Meaningful Measures Initiative moves payment toward value by focusing everyone’s efforts on the same quality areas, with eight objectives:

• Address high-impact measure areas that safeguard public health.
• Make measures patient-centered and meaningful to patients.
• Make measures outcome-based where possible.
• Fulfill each program's statutory requirements.
• Minimize the level of burden for measured entities.
• Make opportunity for improvement.
• Address measure needs for population-based payment through alternative payment models.
• Align measures across programs and/or with other payers (Medicaid, commercial payers).

How did CMS identify the focus areas for the Meaningful Measures Initiative?

CMS worked with stakeholders to find the measure areas that most impact our work:

• Identified stakeholders like states and private payers that use quality measurement based on our quality priorities.
• Heard specific feedback from the public and the MAP that measure sets need to be prudent and useful.
• Drew from experts and stakeholders like the National Academy of Medicine, the Agency for Healthcare Research and Quality, the American Hospital Association, and the Core Quality Measures Collaborative, led by America’s Health Insurance Plans, to develop criteria to make measures meaningful to people and actionable for measured entities.

Why are we using the Meaningful Measures Initiative?

The Meaningful Measures Initiative and its Framework help us develop and implement meaningful quality measures that stakeholders can understand and help guide quality measurement efforts. By focusing on the core issues most important to providing high-quality care and improving individual outcomes, CMS can reduce the burden of quality reporting for clinicians and hospitals.

What is the Cascade of Measures?

The Cascade of Measures is a tool that breaks down the Meaningful Measures health care priorities into Goals, Objectives, Measure Families, and examples of individual measures. The Cascade helps identify opportunities for measure alignment and priorities for future measure development by mapping existing measures to the Meaningful Measures Framework. The goal of the Cascade is to guide programs from existing process and outcome measures to the development of more expansive outcome measures and composites at the Objective and Goal level. Learn more about the Cascade of Measures. 

Is there anything new I need to report because of the Meaningful Measures Initiative?

No, CMS doesn’t intend for the Meaningful Measures Initiative to create new requirements or measures for measured entities to report. It’s important to know the difference between Meaningful Measures, an overall guiding initiative, and specific CMS programs, each with different reporting requirements.

The intent of the Meaningful Measures Initiative is to find the highest-priority quality measurement areas to guide future measure set changes in CMS programs. CMS adds and removes measures from measure sets through rulemaking by individual programs for their specific measure sets.

How does the Meaningful Measure Initiative work with the Impact Assessment Report?

Law requires CMS to assess the impact of using endorsed quality measures in programs and initiatives we administer every 3 years and publicly post the results. The 2018 Impact Assessment Report (PDF) organized measure analyses under six Quality Strategy priorities, which aligned closely with the health care quality priorities in the original Meaningful Measures Initiative.

The 2021 Impact Assessment Report (PDF) evaluated how performance measures addressed each area of the same six Quality Strategy priorities and helped us achieve our strategic goals. Key indicator dashboards, like those in the 2018 Impact Assessment Report, show progress in the core issues most important to high-quality care and better patient outcomes.

Tools & Resources

• Quality Conference: The Future of Quality Measurement, 2020 and Beyond —  February 2020 (PPTX) – A PowerPoint presentation delivered during the 2020 CMS Quality Conference that identifies CMS quality measurement priorities, summarizes proposed changes to the Measure-based Incentive Payment System, and defines patient-reported outcome measures and patient-reported outcome performance measures. 
• Meaningful Measures Alignment with 2018 Impact Assessment Key Indicators (PDF) – A crosswalk table that shows how the 2018 Key Indicators align with the six Healthcare Quality Priorities, 19 Meaningful Measure Areas, and related detailed objectives of the CMS Meaningful Measures Initiative. Key Indicators are measures or groups of measures used to gauge performance in a Meaningful Measure Area and track progress critical to providing high-quality care and improving individual outcomes.