: Medicare Access and CHIP Reauthorization Act (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program

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Opportunity ID: 293852
Opportunity Number: TBD
Opportunity Title: : Medicare Access and CHIP Reauthorization Act (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program
Opportunity Category: Discretionary
Opportunity Category Explanation:
Funding Instrument Type: Cooperative Agreement
Category of Funding Activity: Health
Category Explanation:
CFDA Number(s): 93.986
Eligible Applicants: Others (see text field entitled “Additional Information on Eligibility” for clarification)
Additional Information on Eligibility: Clinical specialty societies, clinical professional organizations, patient advocacy organizations, educational institutions, independent research organizations, health systems, and other entities engaged in quality measure development. For this funding opportunity, the above categories are referenced collectively as entity or entities. The language, engaged in quality measure development, pertains to each of the above referenced entities.
Agency Code: HHS-CMS
Agency Name: Department of Health and Human Services
Centers for Medicare & Medicaid Services
Posted Date: May 15, 2017
Last Updated Date: May 15, 2017
Estimated Synopsis Post Date:
Fiscal Year: 2018
Award Ceiling: $6,000,000
Award Floor: $0
Estimated Total Program Funding: $30,000,000
Expected Number of Awards: 10
Description: This forecast is for an upcoming cooperative agreements funding opportunity, in accordance with section 1848(s)(6) of the Social Security Act, as added by section 102 of the Medicare Access and Children’s Health Insurance Program Reauthorization Act of 2015. This funding opportunity will be used for developing, improving, updating or expanding quality measures for use in the Quality Payment Program under the Merit-Based Incentive Payment System and/or Advanced Alternative Payment Models. Recognizing the benefits of measure development by external stakeholders with specific knowledge of clinician and patient perspectives and needs, the funding assistance of these cooperative agreements is specifically designated for entities, external to CMS and other federal agencies, such as clinical specialty societies, clinical professional organizations, patient advocacy organizations, educational institutions, independent research organizations, health systems, and other entities with working knowledge in quality measure development to develop quality measures that could be potentially used for the Quality Payment Program. These external entities provide the needed medical specialty and patient perspectives to lead or support the measure development priorities of the (section 1848(s)(1) of the Social Security Act, as added by section 102 of the Medicare Access and Children’s Health Insurance Program Reauthorization Act of 2015), Measure Development Plan and accordingly, to advance the Quality Payment Program measure portfolio. Specifically, collaboration and support for these entities in measure development will assist CMS in addressing such essential topics as: clinician engagement, burden reduction, consumer informed decisions, critical measure gaps, shared care and payment accountability quality measure alignment, and efficient data collection.This program requires active quality measure development work (developing, improving, updating, or expanding quality performance measures) for inclusion in the Merit-Based Incentive Payment System or alternative payment models based on a measure concept(s) or measure(s) that fulfills the purpose of and is in accordance with the provisions of section 1848(s)(2) of the Social Security Act, as added by section 102 of the Medicare Access and Children’s Health Insurance Program Reauthorization Act of 2015. The output of this work will be one or more fully developed, specified, and tested quality measures for potential use in the Quality Payment Program tracks of the Merit-Based Incentive Payment System or CMS Alternative Payment Model(s). Technical expertise in the full measure development lifecycle from measure conceptualization through implementation is required. Entities without quality measure development technical expertise are encouraged to include or partner with an organization(s) with that expertise to meet program requirements. The full measure development lifecycle is further described in A Blueprint for the CMS Measures Management System(the Blueprint), which can be found here: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/MMS-Blueprint.html. Additionally, a successful candidate will obtain significant clinician and patient input. CMS will provide targeted technical assistance in the form of guidance and direction to aid awardees in their work as a part of the cooperative agreement.For this funding opportunity, at a minimum, there must be an existing measure concept based on evidence of a demonstrated quality gap, variation in performance across clinicians, and opportunity for improvement. Measure development work must comport with section 1848(s)(2) of the Social Security Act, as added by section 102 of the Medicare Access and Children’s Health Insurance Program Reauthorization Act of 2015 and subsequently with the priorities identified in the CMS Quality Measure Development Plan: Supporting the Transition to the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs) found here: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/Final-MDP.pdf. The CMS Quality Measure Development Plan identifies initial priority areas for measure development and gap areas for specialty measures. These priority areas (domains) are: Clinical Care, Safety, Care Coordination, Patient and Caregiver Experience and Population Health and Prevention. The gap areas for specialty measures are: Orthopedic Surgery, Pathology, Radiology, Mental Health, Oncology and Emergency Medicine. However, CMS will accept applications for development of other specialty quality measures whose measures are high impact and also fill an existing gap or need. For example, quality measures for medical conditions or procedures that span the entire episode of care, from inpatient hospitalization through post- acute care settings and/or measures that can be attributed to providers that do not require the patient to have had an outpatient or office visit (e.g., non-face to face encounters) to be included in the initial patient population. These quality measures must also fill an existing gap or need. For further information on priority specialty and subspecialty areas, see the CMS Quality Measure Development Plan: Environmental Scan and Gap Analysis Report found here: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MDP_EScan_GapAnalysis_Report.pdf.
Version: Forecast 2





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