CQMC UPDATES CORE MEASURE SETS TO STRENGTHEN FOCUS ON HEALTH OUTCOMES AND REDUCE BURDEN

The following information was released by the America's Health Insurance Plans (AHIP):

by AHIP

The Core Quality Measures Collaborative (CQMC) today announced updates to nine of its core measure sets for 2025, sharpening the focus on outcomes, addressing key gaps in existing sets, and removing measures that are outdated, redundant, not in use, or no longer necessary as performance is universally high.

The CQMC is a publicprivate partnership convened by AHIP and the Centers for Medicare and Medicaid Services (CMS). It includes more than 75 organizations representing patients, purchasers, health plans, providers, and quality experts that work together to promote aligned, high-value core quality measures for use in value-based care.

For the 2025 update, the CQMC concentrated on three priorities:

Addressing key gap areas where the existing measures did not fully capture high-priority aspects of care, including patient experience, care coordination, and specialty-specific performance.

Adding new outcome-focused measures that reflect performance on complications, disease control, and avoidable utilization.

Removing measures that are outdated or not in use to keep the core sets relevant, feasible, and parsimonious for value-based payment arrangements.

"The health care system needs clear and consistent measures that reflect current clinical practice and support meaningful accountability," said Danielle A. Lloyd, MPH, Senior Vice President of Private Market Innovations and Quality Initiatives at AHIP and CQMC Steering Committee Chair. "In 2025, the CQMC addressed key gaps, prioritized outcome measures, and retired measures that no longer deliver valuereducing reporting burden while sharpening the focus on results that matter for patients."

The CQMC core sets cover major clinical domains commonly used in alternative payment models and other value-based arrangements, including:

Accountable Care Organizations/Patient-Centered Medical Homes/Primary Care

Cardiology

Gastroenterology

HIV and Hepatitis C

Medical Oncology

Obstetrics and Gynecology

Orthopedics

Pediatrics

Behavioral Health

Neurology

Across these domains, the core sets are designed to streamline measurement so health plans and clinicians can rely on a concise list of measures that support performance improvement and comparability across programs.

About the CQMC

The CQMC is a diverse coalition of health care leaders representing more than 75 consumer groups, medical associations, health insurance providers, purchasers, and other quality stakeholders, all working together to develop and recommend core sets of measures by clinical area to assess and improve the quality of health care in America. The CQMC is a public-private partnership between AHIP and the Centers for Medicare and Medicaid Services (CMS). The CQMC is currently convened by Battelle's Partnership for Quality Measurement (PQM) in its role as the consensus-based entity. Click here for more information on the CQMC core measure sets.

About AHIP

AHIP is the national association whose members provide health care coverage, services, and solutions to hundreds of millions of Americans every day. We are committed to market-based solutions and public-private partnerships that make health care better and coverage more affordable and accessible for everyone. Visit www.ahip.org to learn how working together, we are Guiding Greater Health.

About the Centers for Medicare and Medicaid Services

Established in 1965, the Centers for Medicare and Medicaid Services (CMS) is the largest insurance payer in the United States, covering more than 160 million Americans through programs such as Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). Using a collaborative and human centered design approach, CMS develops and maintains quality measurement programs, the oversight and standards certification program, and determines coverage analysis. CMS sponsors numerous quality improvement and innovation programs. Through various pilot programs run by CMS and the Quality Improvement Networks/Quality Improvement Organizations (QIN/QIO). . CMS is leading the country in promoting value-based health care to improve the lives of all patients. CMS programs help set health care standards used by many organizations across health care today.