CMS Removes Two Quality Measures Relating to Pain

Posted on October 8, 2019 by Julie Apold

The Centers for Medicare & Medicaid Services (CMS) plans to remove two quality measures relating to pain from the Nursing Home Compare website and the Five Star Quality Rating System.   

In a memo from its Quality, Safety Oversight Group, CMS noted the severity of the opioid crisis and explained that it wishes to avoid any potential scenario where performance on pain quality measures may inappropriately contribute to a decision to seek administration of an opioid.

To support this, CMS will be removing two measures from Nursing Home Compare and the Five Star Quality Rating System this month:

• Percentage of short-stay residents who report moderate to severe pain.
• Percentage of long-stay residents who report moderate to severe pain.

The memo also advises providers that, beginning in April 2020, CMS will begin increasing quality measure (QM) thresholds by 50% of the average rate of improvement in QM score, and will do so every six months. For example, if there is an average rate of improvement of 2%, the QM threshold would be raised 1%.

“In addition to incentivizing continuous quality improvement, this action reduces the need to have larger adjustments to the thresholds in the future,” the memo notes. This announcement ties back to previously-announced changes relating to the Quality Measure domain of the Five-Star system that CMS is implementing in order to incentivize quality improvement.

We will provide further analysis of these announced changes in a future edition of Advantage.