Medicare Seeks Feedback on Specialist Physician Measure Sets

January 2022

The Centers for Medicare & Medicaid Services, the agency that runs Medicare, is accepting stakeholders’ recommendations for measures used to evaluate specialist physician practices. As part of Medicare’s Quality Payment Program (QPP), these measures influence clinical priorities and patterns of care to align with best practices.

An example of a specialty measure is Statin Therapy, which is defined as the percentage of the patients at high risk for cardiovascular events who were prescribed or were on statin therapy during the measurement period. This measure is included in the specialty measure sets for cardiology, endocrinology, family medicine, internal medicine, and preventive medicine.

The QPP currently includes measure sets for the following specialties, among others:

  • Allergy/Immunology
  • Cardiology
  • Dentistry
  • Dermatology
  • Endocrinology
  • Family Medicine
  • Gastroenterology
  • Geriatrics
  • Hospitalists
  • Infectious Disease
  • Internal Medicine
  • Mental/Behavioral Health
  • Nephrology
  • Neurology
  • OB/GYN
  • Oncology
  • Ophthalmology
  • Pediatrics
  • Preventive Medicine
  • Pulmonology
  • Radiation Oncology
  • Rheumatology
  • Urology

Life sciences companies should be aware of the measures that apply to their therapeutic areas. The measures provide an opportunity to shape clinical practice and to engage with physicians to improve patient care and manage population health. There may also be opportunities to shape the measures to align with key patient care opportunities as new therapies come to market. Real Chemistry’s Value and Access team is expert in the various QPP performance measures and the Medicare public comment process.

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