AAFP Notches Administrative Simplification Win in CMS Final Rule
New Core Set Requirement Answers Academy Advocacy
Sept. 11, 2023, News Staff — In a victory for the AAFP’s advocacy, CMS has finalized a rule requiring state Medicaid agencies to report on a standardized set of quality measures beginning next year. The change will reduce physicians’ administrative complexity and improve oversight and meaningful population-level measurement in Medicaid and CHIP.
“Primary care practices should not have to spend their limited resources tracking down data in order to provide what is required for a state Medicaid agency to report on the core measures,” the Academy said last October in response to a draft of the rule.
The final rule, which goes into effect Jan. 1, 2024, governs core-set reporting for Children’s Health Care Quality Measures for
- Medicaid,
- CHIP,
- the behavioral health measures on the Core Set of Adult Health Care Quality Measures for Medicaid, and
- the Core Sets of Health Home Quality Measures for Medicaid.
This use of standardized quality reporting answers the Academy’s call to improve Medicaid oversight.
The rule is the latest in a series of moves CMS has made to align quality measures across its programs through adoption of the Universal Foundation for quality measures. The Academy has supported these efforts while strongly urging CMS to work toward greater measure alignment across payers, which would meaningfully reduce physicians’ reporting burden and have other positive effects.
Stacey Bartell, M.D., the AAFP’s medical director for career and practice, participated last year in reviewing the proposed measure sets for calendar year 2025 and will do so for 2026, as well.