QPP Submissions API Documentation Page — Single- and Multiple-Performance Rate Measurements — Difference Between “registry” and “normal”

[Randal Roe (Alpha II Registry)]

From https://cmsgov.github.io/qpp-submissions-docs/measurements:

Single-Performance Rate Measurements

Single-Performance Rate Measurements are applicable to Quality measures. There are two types of Single-Performance Rate Measurements: registry and normal. The difference between the two is that for Registry Single-Performance Rate Measurements, the performanceRate field is both writable and required.

And also:

Multi-Performance Rate Measurements

Multi-Performance Rate Measurements are applicable to Quality measures. There are two types of Multi-Performance Rate Measurements: registry and normal. The difference between the two is that for Registry Multi-Performance Rate Measurements, the performanceRate field is both writable and required. Multi-Performance Rate Measurements contain multiple strata and the stratum field is required for each.

We see the sentence that states the difference between “registry” and “normal” performance rate measurements. But what exactly does this mean? For all quality measures — with the possible exceptions of measure 459, 460, and 461, which are identified in measures-data.json as having "metricType": "nonProportion" —, aren’t they always “registry” and therefore the performanceRate field is always required?

In practical terms, shouldn’t we always include

performanceMet,

performanceNotMet (unless there were no “not met” occurrences, of course), and

performanceRate?

Are there examples of measurements for each of these two performance rate measurement types (“registry” and “normal”)?

Any help and background you can provide will be greatly appreciated.

Thank you.

Randal Roe

Alpha II Registry

[Sarah White]

Hi Randal,

That wording is definitely confusing. In these cases registry means a measure maintained by a QCDR or Registry and normal means a normal MIPS quality measure. So an example of a registry measure would be those with letters in their measureId like ACEP19. You'll notice on the measures repository ACEP19 has a field called "isRegistryMeasure" and it's value is "true". It also has a a "metricType" of "registrySinglePerformanceRate". So for the documentation you've shared the differences in which fields you should report is in the "metricType" field - "singlePerformanceRate" and "multiPerformanceRate" measures are normal MIPS measures. "registrySinglePerformanceRate" and "registryMultiPerformanceRate" measures are QCDR measures and can require additional fields for submission. For example, "performanceRate" for "registrySinglePerformanceRate" is labeled as "writable for registry single-performance rate only".

Non proportion measures are slightly different. I'd read the guidance attached to this Google Group post for the distinction between reporting measures 459, 460, and 461 vs QCDR nonProportion measures - https://groups.google.com/forum/#!topic/qpp-apis/WqNS1V2sTQY

Sarah White

Business Analyst

Nava

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[Andrew Limburg]

Sarah White,

To drill down a little more, what we are wanting to know is whether the PerformanceRate field is a required field.

In the 2017 reporting year, it was not required.  We did not send the PerformanceRate, it was returned to us by the API. Additionally, the 2018 sandbox does not require us to send the PerformanceRate field and it is returned to us.  Having said that, for the 2018 reporting year, per the documentation that Randal provided, it is indicating that PerformanceRate is a required field, giving the impression that we are responsible for sending it.  

Therefore, based upon the 2018 sandbox and the 2017 API (and 2017 sandbox), we are of the opinion that the documentation is incorrect and the PerformanceRate field is not required.

Please confirm.

Thank you,

Andrew Limburg

Alpha II Registry 

[Sarah White]

For nonProportion measures it is now a required field. This is explained in the Google Group post I linked too and within the attached document. It's also indicated in the Developer Documents under the nonProportion metric type information on the same page that Randal included screen shots from - https://cmsgov.github.io/qpp-submissions-docs/measurements#non-proportion-measurements. Please note that the field notes say "writable" and do not say "optional". The 2018 sandbox/Developer Preview and production API require this field.

For other metric types, such as singlePerformanceRate it is not required as it is generated by the API. That's why the notes about those fields under those specific metric types specify that it is only for registry measures - those with metric type "registrySinglePerformanceRate" or "registryMultiPerformanceRate". 

Though fields may be used across multiple metric types - their requirements may change based on the information that is required to be submitted vs information that the API calculates.

Sarah White

Business Analyst

Nava

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