At a glance
Find guidelines and quality measures that establish standards for care and help measure the quality of HIV, STD, viral hepatitis and tuberculosis-related health care services. Where applicable, their use in public and select private quality measurement programs is also indicated.
Quality measures overview
Introduction to quality measures
Quality measures, which can also be referred to as Clinical Quality Measures (CQMs) and electronic Clinical Quality Measures (eCQMs), are tools that help measure or quantify healthcare processes, outcomes, patient perceptions, and organizational structure and/or systems that are associated with the ability to provide high-quality health care. Measurement is a step towards improving health care quality, and quality measures help drive that improvement through a consistent and accountable approach. Please access the CMS Quality Measures webpage for more information.
Select quality reporting and payment programs
Quality measures are used within a wide variety of quality reporting, accreditation, and payment programs and initiatives. Programs and associated measure sets frequently used to evaluate the quality of care provided by clinicians, health plans, and states include some of the following:
- Merit-Based Incentive Payment System (MIPS) Program
- Medicaid Adult Core Set
- Medicaid Child Core Set
- Healthcare Effectiveness Data and Information Set (HEDIS)
- Qualified Health Plan Quality Rating System (QHP QRS)
- HRSA Uniform Data System – Health Center Data Reporting Requirements
- HRSA HIV/AIDS Bureau – Ryan White HIV/AIDS Program
Quality measure summary tables
Summary table details
A Summary Table is available for HIV, viral hepatitis, STD, and TB related measures. Each table includes the following:
- Measure Name: Lists the name of the measure as it appears in the quality program(s).
- Brief Description: Describes the population and activity that the measure is monitoring.
- NQF ID: Provides the ID in the table if the measure is endorsed by the National Quality Forum.
- eCQM ID: Provides the number if the measure is also available as an eCQM.
- Steward: Entity that created the quality measure and manages periodic updates. The stewards included in the summary tables are the following:
- American Academy of Dermatology (AAD)
- American College of Rheumatology (ACR)
- American Gastroenterological Association (AGA)
- Centers for Disease Control and Prevention (CDC)
- Health Resources and Services Administration (HRSA)
- National Committee for Quality Assurance (NCQA)
- Physician Consortium for Performance Improvement (PCPI)
- Programs Currently Using: Lists some of the quality programs that use the quality measure. (See Quality Measures Overview above.)
HIV quality measures table
| Measure Name | Brief Description | NQF ID | eCQM ID | Steward | Programs Currently Using |
|---|---|---|---|---|---|
| HIV Screening | Percentage of patients at the start of the measurement period who were between 15-65 years old when tested for HIV | CMS349 | CDC | MIPS Program | |
| HIV/AIDS: Sexually Transmitted Diseases – Screening for Chlamydia, Gonorrhea, and Syphilis | Percentage of patients aged 13 years and older with a diagnosis of HIV/AIDS, who have received chlamydia, gonorrhea, and syphilis screenings at least once since the diagnosis of HIV infection | 0409 | HRSA | MIPS Program | |
| HIV Medical Visit Frequency | Percentage of patients, regardless of age with a diagnosis of HIV who had at least one medical visit in each 6-month period of the 24-month measurement period, with a minimum of 60 days between medical visits | 2079 | 3209e | HRSA | MIPS Program
HRSA HIV/AIDS Bureau – Ryan White HIV/AIDS Program – Core Measures |
| HIV Viral Load Suppression | Percentage of patients, regardless of age, with a diagnosis of HIV with a HIV viral load less than 200 copies/mL at last HIV viral load test during the measurement year | 2082 | 3210e | HRSA | MIPS Program
HRSA HIV/AIDS Bureau – Ryan White HIV/AIDS Program – Core Measures |
| HIV Linkage to Care | Percentage of patients whose first-ever HIV diagnosis was made by health center personnel between December 1 of the prior year and November 30 of the measurement period and who were seen for follow up treatment within 30 days of that first-ever diagnosis | HRSA | Uniform Data System – Health Center Data Reporting Requirements (HRSA) | ||
| Gap in HIV Medical Visits | Percentage of patients, regardless of age, with a diagnosis of HIV who did not have a medical visit in the last 6 months of the measurement year | 2080 | HRSA | HRSA HIV/AIDS Bureau – Ryan White HIV/AIDS Program – Core Measures | |
| Prescription of HIV Antiretroviral Therapy | Percentage of patients, regardless of age, with a diagnosis of HIV prescribed antiretroviral therapy for the treatment of HIV infection during the measurement year | 2083 | 3211e | HRSA | HRSA HIV/AIDS Bureau – Ryan White HIV/AIDS Program – Core Measures |
| Annual Retention in Care | Percentage of patients, regardless of age, with a diagnosis of HIV who had at least two (2) encounters within the 12-month measurement year | HRSA | HRSA HIV/AIDS Bureau – Ryan White HIV/AIDS Program – Core Measures | ||
| HIV/AIDS: Pneumocystis jiroveci pneumonia (PCP) Prophylaxis | Percentage of patients aged 6 weeks or older with a diagnosis of HIV/AIDS, who were prescribed Pneumocystis jiroveci pneumonia (PCP) prophylaxis | 0405 | NCQA | HRSA HIV/AIDS Bureau – Ryan White HIV/AIDS Program – Core Measures |
Viral hepatitis* quality measures table
| Measure Name | Brief Description | NQF ID | eCQM ID | Steward | Programs Currently Using |
|---|---|---|---|---|---|
| Childhood Immunization Status | Percentage of children 2 years of age who had four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV), one measles, mumps and rubella (MMR); three Haemophilus influenza type B (HiB); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday | 0038 | CMS117 | NCQA | MIPS Program
Uniform Data System – Health Center Data Reporting Requirements (HRSA) |
| Annual Hepatitis C Virus (HCV) Screening for Patients who are Active Injection Drug Users | Percentage of patients, regardless of age, who are active injection drug users who received screening for HCV infection within the 12-month reporting period | AGA | MIPS Program | ||
| Hepatitis C: Screening for Hepatocellular Carcinoma (HCC) in Patients with Cirrhosis | Percentage of patients aged 18 years and older with a diagnosis of chronic hepatitis C cirrhosis who underwent imaging with either ultrasound, contrast enhanced CT or MRI for hepatocellular carcinoma (HCC) at least once within the 12-month submission period | AGA | MIPS Program | ||
| One-Time Screening for Hepatitis C Virus (HCV) for all Patients** | Percentage of patients age >= 18 years who received one-time screening for hepatitis C virus (HCV) infection | AGA | MIPS Program |
*A Sustained virological response (SVR) in the treatment of hepatitis C infection measure is being developed by AGA and is currently undergoing testing.
**NQF has a version of this measure, 3059e – One-Time Screening for Hepatitis C Virus (HCV) for Patients at Risk, which is no longer utilized in MIPS.
STD quality measures table
| Measure Name | Brief Description | NQF ID | eCQM ID | Steward | Programs Currently Using |
|---|---|---|---|---|---|
| Immunizations for Adolescents | The percentage of adolescents 13 years of age who had one dose of meningococcal vaccine, one tetanus, diphtheria toxoids and acellular pertussis (Tdap) vaccine, and have completed the human papillomavirus (HPV) vaccine series by their 13th birthday | 1407 | NCQA | MIPS Program | |
| Chlamydia Screening in Women | The percentage of women 16-24 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement period | 0033 | CMS153 | NCQA | MIPS ProgramMedicaid Adult Core Set |
| HIV/AIDS: Sexually Transmitted Diseases – Screening for Chlamydia, Gonorrhea, and Syphilis | Percentage of patients aged 13 years and older with a diagnosis of HIV/AIDS for whom chlamydia, gonorrhea, and syphilis screenings were performed at least once since the diagnosis of HIV infection | 0409 | HRSA | MIPS Program |
*** The child core set measure is specific to ages 16-20.
Tuberculosis quality measures table
| Measure Name | Brief Description | NQF ID | eCQM ID | Steward | Programs Currently Using |
|---|---|---|---|---|---|
| Tuberculosis Screening Prior to First Course Biologic Therapy | If a patient has been newly prescribed a biologic disease-modifying anti-rheumatic drug (DMARD) therapy, then the medical record should indicate TB testing in the preceding 12-month period | ACR | MIPS Program
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| Psoriasis: Tuberculosis (TB) Prevention for Patients with Psoriasis, Psoriatic Arthritis and Rheumatoid Arthritis on a Biological Immune Response Modifier | Percentage of patients, regardless of age, with psoriasis, psoriatic arthritis and/or rheumatoid arthritis on a biological immune response modifier whose providers are ensuring active tuberculosis prevention either through negative standard tuberculosis screening tests or are reviewing the patient’s history to determine if they have had appropriate management for a recent or prior positive test | AAD | MIPS Program (2021) | ||
| Rheumatoid Arthritis (RA): Tuberculosis Screening | Percentage of patients aged 18 years and older with a diagnosis of rheumatoid arthritis who have documentation of a tuberculosis (TB) screening performed within 6 months prior to receiving a first course of therapy using a biologic disease-modifying anti-rheumatic drug (DMARD) | 2522**** | ACR | MIPS Program (2020) |
**** Approved for trial use