ACR Endorsed Measures

The ACR endorses quality measures related to the care of rheumatic disease. Sometimes these measures have been developed and tested by the ACR, but at times the ACR endorses or promotes the use of measures that have been developed and tested by others. The ACR’s ultimate goal is for providers of rheumatology care to have one parsimonious set of meaningful quality measures to use in external quality reporting, improvement and performance programs.

Rheumatoid Arthritis

The ACR has most recently developed and tested the following RA measures (2014), which are being used in the ACR’s RISE registry:

  1. RA – disease activity measurement: Percentage of patients 18 years and older with a diagnosis of rheumatoid arthritis and >=50% of total number of outpatient encounters in the measurement year with assessment of disease activity using a standardized measure
  2. RA – functional status assessment: Percentage of patients 18 years and older with a diagnosis of rheumatoid arthritis for whom a functional status assessment was performed at least once during the measurement period
  3. RA – TB screening: Percentage of patients 18 and older with a diagnosis of rheumatoid arthritis who have documentation of a TB screening performed within 12 months prior to receiving a first course of therapy using a biologic DMARD
  4. RA – DMARD therapy: Percentage of patients 18 and older with a diagnosis of rheumatoid arthritis who are prescribed DMARD therapy within 12 months

Learn more in the ACR paper, Development of the American College of Rheumatology’s Rheumatoid Arthritis Electronic Clinical Quality Measures, published November 2016.

RA Measure Development Project

The ACR previously participated in an RA measure development project (2008) that resulted in the following measures, all of which are included in the CMS Physician Quality Reporting System (PQRS) RA measure group and are used in the ACR’s RISE registry:

  1. RA – disease activity measurement: Percentage of patients 18 years and older with a diagnosis of rheumatoid arthritis who have an assessment and classification of disease activity at least once within 12 months
  2. RA – functional status assessment: Percentage of patients 18 years and older with a diagnosis of rheumatoid arthritis for whom a functional status assessment was performed at least once within twelve months
  3. RA – TB screening for first course biologic: Percentage of patients 18 years and older with a diagnosis of rheumatoid arthritis who have documentation of a tuberculosis (TB) screening performed and results interpreted within 6 months prior to receiving a first course of therapy using a biologic disease-modifying antirheumatic drug (DMARD)
  4. RA – glucocorticoid management: Percentage of patients 18 years and older with a diagnosis of rheumatoid arthritis who have been assessed for glucocorticoid use and, for those on prolonged doses of prednisone > 10 mg daily (or equivalent) with improvement or no change in disease activity, documentation of glucocorticoid management plan within 12 months
  5. RA – assessment of prognosis: Percentage of patients 18 years and older with a diagnosis of rheumatoid arthritis who have an assessment and classification of disease prognosis at least once within 12 months

A sixth measure, developed by the National Committee on Quality Assurance (NCQA), is also part of the PQRS RA measure group:

6. RA – DMARD therapy: Percentage of patients 18 years and older with a diagnosis of rheumatoid arthritis who were prescribed, dispensed or administered at least one ambulatory prescription for a DMARD

Gout

The ACR has developed the following gout measures (2014), which are being used in the ACR’s RISE registry and tested in U.S. clinical practices:

  1. Serum urate target: Percentage of patients aged 18 and older with a diagnosis of gout treated with urate-lowering therapy (ULT) for at least 12 months, whose most recent serum urate result is less than 6.8 mg/dL.
  2. ULT therapy: Percentage of patients aged 18 and older with a diagnosis of gout and either tophus/tophi or at least two gout flares (attacks) in the past year who have a serum urate level > 6.0 mg/dL, who are prescribed urate lowering therapy (ULT)
  3. Serum urate monitoring: Percentage of patients aged 18 and older with a diagnosis of gout who were either started on urate lowering therapy (ULT) or whose dose of ULT was changed in the year prior to the measurement period, and who had their serum urate level measured within 6 months

Glucocorticoid-induced Osteoporosis

The ACR has developed GIOP measures that are currently being tested in the ACR’s RISE registry. The measures that pass the testing phase will be posted here when testing is complete.