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CMS-1403-FC Comment: Several commenters commended NQF for the scientific rigor of its structure and review processes. Some commenters in favor of establishing a single consensus organization entity whose approval would qualify a measure for PQRI inclusion went on to name NQF as the leading or only named candidate for such an organization. Response: As stated previously, we have stated a policy preference for NQF-endorsed measures. However, we are not limited by statute to using only NQF-endorsed measures. Comment: We received some comments supportive of having measures that originate from a variety of sources and opposed to requiring PQRI measurement development to come solely from physician controlled organizations. At the same time, several commenters suggested we consider establishing as policy that quality measures to be used by, and analyzed at the level of, individual PQRI-eligible professionals, must be developed by clinician controlled organizations to assure relevance and promote uptake by the eligible professional community. Multiple commenters suggested that explicit preference be given for measures developed or endorsed by physician specialty societies, in the context of consensus-organization review and CMS measure selection processes. Some commenters stated that 598
CMS-1403-FC the AMA–PCPI should be the sole source for physician level measures. Several commenters specifically presented an interpretation of the requirement under section 1848(k)(2)(B)(i) of the Act for the 2009 PQRI measures to include measures submitted by a physician specialty as meaning that the 2009 PQRI should include only measures developed by physician organizations, to assure physician control of available measures applicable to assessing the clinical performance of individual physicians. Response: Physician involvement and leadership is standard in the work of both measure developers and consensus organizations. As a result, physicians are actively involved at all levels of measure development and consensus adoption and endorsement. We are in agreement that physician expertise is an important ingredient in measure development and in the consensus process. We further recognize the leadership of physician organizations, as is reflected in the large number of physician quality measures included in PQRI which were developed by the AMA–PCPI and its participating specialty societies. However, we do not agree that physicians should be in complete control of the process of measure development, as would be the case if measures were required to be developed 599
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<strong>CMS</strong>-1403-FC<br />
the AMA–PCPI should be the sole source for physician level<br />
measures. Several commenters specifically presented an<br />
interpretation of the requirement under section<br />
1848(k)(2)(B)(i) of the Act for the 2009 PQRI measures to<br />
include measures <strong>submitted</strong> by a physician specialty as<br />
meaning that the 2009 PQRI should include only measures<br />
developed by physician organizations, to assure physician<br />
control of available measures applicable to assessing the<br />
clinical performance of individual physicians.<br />
Response: Physician involvement and leadership is<br />
standard in the work of both measure developers and<br />
consensus organizations. As a result, physicians are<br />
actively involved at all levels of measure development and<br />
consensus adoption and endorsement. We are in agreement<br />
that physician expertise is an important ingredient in<br />
measure development and in the consensus process. We<br />
further recognize the leadership of physician<br />
organizations, as is reflected in the large number of<br />
physician quality measures included in PQRI which were<br />
developed by the AMA–PCPI and its participating specialty<br />
societies.<br />
However, we do not agree that physicians should be in<br />
complete control of the process of measure development, as<br />
would be the case if measures were required to be developed<br />
599