NCQA’s Person-Centered Outcome Measures Recommended for MIPS
March 25, 2025 · Becky Kolinski
NCQA’s person-centered outcome (PCO) measures continue to attract the interest of the quality improvement community: The measures were recently recommended for inclusion in the Merit-Based Incentive Payment System (MIPS) for Medicare. (CMS will release the final list of measures in July.)
“PCO measures align with the CMS universal foundation set, which seeks to streamline quality measurement and reduce burden,” says NCQA’s Daniela Lawton, Director, Chronic Conditions. “These measures have universal appeal, and they are flexible enough to be applied to many different populations and accountability levels—including health plans, care delivery organizations and individual clinicians.”
Why Are PCO Measures Important?
Nearly 30% of Medicare beneficiaries have complex health care needs, and more than 14 million people in the U.S. need long-term services and supports. These numbers grow every year. PCO measures work in tandem with clinical care to help people living with complex health needs make progress toward a health goal that matters to them.
PCO measures have three components:
- Identify a goal and document it in a structured way, using goal attainment scaling or a patient-reported outcome measure.
- Follow up on the goal.
- Assess goal achievement.
Clinicians throughout the care continuum, and community-based services, can use this approach to identify what’s important to a person. Defining a person’s goals—and ensuring that their care is consistent with those goals—can reduce unwanted treatment and lead to meaningful improvement.
How Will PCO Measures Be Used in MIPS?
MIPS is part of Medicare’s Quality Payment Program, which rewards clinicians who provide high-quality care. Clinicians can earn performance-based payment adjustment based on four areas: quality measures, process improvement activities, cost, promoting interoperability.
Organizations and individual clinicians can choose which measures they want to report on for MIPS. PCO measures were recommended for the following categories:
- Traditional MIPS Quality Measures: Family medicine, internal medicine, geriatrics, physical medicine and neurology.
- MIPS Value Pathways: Primary care and neurology.
“There is a lot of interest in patient-reported outcomes across the industry, and many clinicians are collaborating with patients on goal setting—but are not using a structured approach to measurement,” says Lawton. “We’ve developed free training and other resources to help clinicians implement standardized PCO measures.”
How Does the Measure Approval Process Work?
Every year, CMS releases the Measures Under Consideration list of quality and efficiency measures proposed for use in the Medicare program. These measures go to public comment and are reviewed by Advisory and Recommendation Groups as part of the pre-rulemaking measure review process.
The Partnership for Quality Measurement Committee met in January to assess whether the measures under consideration are appropriate for use in CMS value-based care programs for Medicare beneficiaries. The NCQA measures were presented to the Clinician Advisory Group and Recommendation Group and NCQA staff addressed questions.
“NCQA had four measures up for review this year,” says Lawton. “In addition to the PCO measures, our Adult Immunization Status measure—which is already part of MIPS—was recommended for inclusion in the Medicare Part C Star Ratings.”
You can view the full committee report here.
Learn More
To learn more about PCO measures:
NCQA developed person-centered outcome measures with support from the John A. Hartford Foundation, the SCAN Foundation and the Gordon and Betty Moore Foundation.
