APA Wins Award From CMS to Develop Quality Measures

APA is one of seven organizations to receive an award from the Centers for Medicare and Medicaid Services (CMS) to help develop mental health and substance use quality measures for CMS’s Quality Payment Program (QPP).

The award is a $5.38 million grant over three years. APA will help develop mental health and substance use quality measures in the domains of measurement-based care, early psychosis, opioid misuse, suicide risk, and patient care experiences.

The QPP is the updated reimbursement system for CMS that was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). MACRA authorized CMS to provide incentives that encourage physicians to focus on quality, value of care, and patient health. QPP consists of two participation pathways for doctors and other clinicians—the Merit-based Incentive Payment System (MIPS), which measures performance in four categories to determine an adjustment to Medicare payment, and Advanced Alternative Payment Models, or Advanced APMs, in which clinicians may earn an incentive payment through sufficient participation in risk-based payment models.

APA will work with the National Committee for Quality Assurance, a nonprofit organization that is experienced at developing quality measures. A goal will be to minimize the burden of measurement by eliminating redundancies and low-value quality measures from the QPP. In a statement announcing the award, CMS said it had removed or proposed to eliminate reporting requirements for 105 measures across the agency’s programs, saving health care professionals $178 million over the next three years. 

APA will use its PsychPRO registry to test these quality measures. PsychPRO is a CMS-certified Qualified Clinical Data Registry.

“APA is proud to take a leading role in shaping quality measures for our field,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A. “This grant will help us ensure that patients are receiving the highest standards of psychiatric care and that providers can easily report and be reimbursed for providing high-quality services.”

The other six organizations receiving awards and their specialty areas of measurement development are Brigham and Women’s Hospital, orthopedic surgery; American Society for Clinical Pathology, pathology; the Regents of the University of California, San Francisco, radiology; the University of Southern California, mental health and substance use; Pacific Business Group on Health, oncology; and the American Academy of Hospice and Palliative Care, palliative care. ■