Quality Measure Rating Thresholds Changing on Care Compare

In a sign that the Centers for Medicare and Medicaid Services (CMS) is getting back to “normal” after a focus on COVID-19 everything for the past couple years, the Agency made an announcement today that planned updates to Care Compare will be effective with the April 2022 refresh. Specifically, Quality Measure (QM) thresholds will be increased by 50% of the average rate of improvement in QM rating scores every six months.

These changes were initially announced in March 2019 in a QSO Memo, “April 2019 Improvements to Nursing Home Compare and the Five Star Rating System” (QSO-19-08-NH) but were put on hold due to the COVID-19 PHE. The purpose of adjusting the ratings thresholds is to “encourage and incentivize” continuous quality improvement. An updated Five-Star Users’ Guide will be released along with the updates.

Email Announcement from CMS regarding Post-Acute Quality Reporting Programs:

Quality Measure Rating Threshold Changes with the April 2022

Refresh In March 2019, CMS released memorandum QSO-19-08-NH, which outlined a plan to update the quality measure (QM) rating thresholds every six months. The plan was to increase the thresholds by 50% of the average rate of improvement in QM rating scores. For example, if there is an average rate of improvement of 2%, the QM rating thresholds would be raised 1%. Similar to setting new thresholds, this action also aims to incentivize continuous quality improvement. Additionally, it will reduce the need to have larger adjustments to the thresholds in the future. The initial threshold changes were scheduled to occur in April 2020 but were put on hold due to the COVID-19 Public Health Emergency. CMS plans to implement the QM threshold changes with the April 2022 refresh. At that time, CMS will also release a new Five-Star Quality Rating System Technical Users Guide with the updated QM rating thresholds.

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