Cascade of Meaningful Measures 

CMS continues to evolve Meaningful Measures 2.0 and the Cascade of Meaningful Measures framework to reflect the quality measurement priorities of the Agency.

The Cascade of Meaningful Measures is a tool to help prioritize existing health care quality measures, align or reduce measures where there are too many, and identify gaps where new measures may need to be developed. The tool starts by utilizing the eight health care priorities of the Meaningful Measures 2.0 Framework (Figure 1), which consists of eight health care priorities: Person-Centered Care, Safety, Chronic Conditions, Seamless Care Coordination, Social Drivers of Health, Affordability and Efficiency, Wellness and Prevention, and Behavioral Health. 

Figure 1. Meaningful Measures 2.0 Framework

Reading from left to right, the Cascade of Meaningful Measures describes, in increased detail of components of the health care system that are being measured. It moves from the eight Meaningful Measures health care priorities to goals and objectives. Goals and objectives for each health care priority were identified through peer-reviewed and gray literature searches, as well as stakeholder input. We define these terms below.

• Priorities: These are the eight Meaningful Measures 2.0 health care priorities for quality measurement and improvement
• Goals: Key measurable building blocks of quality that support each priority
• Objectives: Measurable indicators used to assess goal performance and comprised of one or more measures

CMS programs leverage the Cascade to identify possibilities for measure alignment and to prioritize areas for additional measure development. As depicted by the right-to-left arrow at the bottom of Figure 2, the Cascade ultimately helps programs move from existing process and outcome measures to the development of more expansive outcome measures and composites at the Objective and Goal levels.

Figure 2. Cascade of Meaningful Measures Schematic

Archive

Cascade of Meaningful Measures Framework (XLSX) – March 2023