08-03-2023_BoardBook

Medical Groups and Clinician Quality Measures

Medical practice and clinical quality measures are collected at the individual and group levels.

Clinicians who care for patients in Medicare (Part B) have two tracks to choose from in the CMS Quality

Payment Program based on their practice size, specialty, location, or patient population (CMS, Quality

Payment Program, 2022). The primary track is the Merit-based Incentive Payment System (MIPS). Under

MIPS, medical groups and clinicians are required to collect a minimum number of measures (at least 6 of

200 measures) depending on the size and type of medical practice, which typically includes one

outcome measure or high-priority measure, or a complete specialty measure set (CMS, Explore

Measures & Activities, 2022). Clinicians may otherwise collect data on different types of measures to

meet the submission requirement for the minimum of 6 measures. The MIPS includes two obesity

specific measures as part of the full measures set, the adult obesity measure - Preventive Care and

Screening: Body Mass Index (BMI) Screening and Follow-Up Plan, and the pediatric obesity measure -

Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (CMS,

Measure Inventory Tool, 2023).

Medical groups and clinicians that serve low-income and under resourced populations may also

report on the Medicaid Core Measure Set for pediatrics using the same weight assessment measure

described. Medicaid does not require any obesity or weight related measures for the adult population.

Each year, CMS initiates a process to review and add quality measures called the Measures Under

Consideration list. There are no obesity or weight related measures on the current MUC list (CMS,

Measures Under Consideration List, 2022).

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