Exploring Episode-Based Approaches for Medicare Performance Measurement, Accountability and Payment Final Report. Medicare Collects Quality Performance Data across Many Settings and Conditions


For the FFS program, Medicare currently collects data on quality measures for six different health care settings:

  1. Hospital inpatient,
  2. Hospital outpatient,
  3. Physicians/practitioners/therapists,
  4. Skilled nursing facilities (SNFs),
  5. Home health agencies (HHAs), and
  6. Dialysis facilities. 

As previously described, four settings have financial incentives associated with the reporting of measures to CMS: (1) hospital inpatient, (2) hospital outpatient, (3) home health agencies, and (4) physicians. Public reporting of performance measures currently occurs for providers in four settings: (1) hospital inpatient, (2) HHAs, (3) SNFs, and (4) dialysis facilities.

There are 249 performance measures submitted to CMS in the six provider settings, and these measures cover 53 different clinical conditions/procedures as well as patient experience in the hospital setting, the presence of health information technology in physician offices, and some patient functional status measures that are not disease/condition specific for skilled nursing facilities and home health. 

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