Center for Clinical Standards and Quality

The Center for Clinical Standards and Quality is a unit of the U.S. Centers for Medicare & Medicaid Services responsible for health care quality, access, and evaluation.

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Quality Improvement Organizations: Organizations contracted by Medicare to improve the quality and value of care for beneficiaries. The center oversees this program, which reviews care and supports local quality improvement.
Conditions of Participation: Federal health and safety requirements providers must meet to participate in Medicare and Medicaid. These requirements provide a core regulatory tool for assuring baseline care and safety.
Centers for Medicare & Medicaid Services: A U.S. federal agency that administers Medicare, Medicaid, and the Children’s Health Insurance Program. The center is a component of this agency, not a separate federal department.
Hospital readmission: An admission to a hospital occurring after a patient has recently been discharged from one. Readmission measures can affect payment and influence hospitals’ efforts to coordinate follow-up care.
Hospital Inpatient Quality Reporting Program: A CMS program requiring hospitals to report specified quality measures to receive full Medicare payment updates. It exemplifies the center’s use of reporting requirements to assess hospital performance.
National Quality Forum: A nonprofit organization that endorses health care performance measures through a consensus process. Measure endorsement helps inform the standards and reporting systems the center administers.
Medicare: A U.S. federal health insurance program primarily serving older adults and some younger people with disabilities. Many of the center’s standards and quality programs govern Medicare-covered care.
Patient safety: The prevention of harm to patients during health care delivery. Federal standards and reporting programs make safety a central target of oversight.
Hospital Value-Based Purchasing: A Medicare program that adjusts hospital payments according to quality and cost measures. It links measured performance to payment policy under the center’s quality agenda.
Healthcare Effectiveness Data and Information Set: A standardized set of performance measures used to evaluate health plans and care. It is a prominent measurement framework that complements federal quality reporting.