2021 CMS QRDA I Implementation Guide for Hospital Quality Reporting

The Centers for Medicare & Medicaid Services (CMS) (@CMSGov) has posted the 2021 CMS Quality Reporting Document Architecture (QRDA) Category I Implementation Guide (IG), Schematron, and Sample File for Hospital Quality Reporting. The 2021 CMS QRDA I IG outlines requirements for eligible hospitals and critical access hospitals (CAHs) to report electronic clinical quality measures (eCQMs) for the calendar year 2021 reporting period for the:

  • Hospital Inpatient Quality Reporting Program
  • Medicare and Medicaid Promoting Interoperability Programs (formerly known as the Medicare and Medicaid Electronic Health Record Incentive Programs) for eligible hospitals and CAHs

The 2021 CMS QRDA I IG contains high-level changes compared with the 2020 CMS QRDA I IG:

  • Alignment with Health Level Seven International® (HL7) Clinical Document Architecture R2 IG: QRDA Category I (QRDA I), Release 1, Standard for Trial Use (STU) Release 5.2, which supports Quality Data Model (QDM) v5.5
  • Guidance for submitting the voluntary Hybrid Hospital-Wide Readmission measure for the July 1, 2021 through June 30, 2022 measurement period

The 2021 CMS QRDA I Schematron updates include:

  • QRDA I Report – CMS (V7): Updated extension to “2020-02-01” and updated to contain Patient Data Section QDM – CMS (V7)
  • Patient Data Section QDM – CMS (V7): Updated extension to “2020-02-01”
  • Incorporated Schematron updates from the base HL7 QRDA I STU Release 5.2 Schematron

The 2021 CMS QRDA I Sample Files updates include:

  • Updates to conform with 2021 CMS QRDA I IG specifications
  • Added a new sample file for voluntary submission of Hybrid Hospital-Wide Readmission measure

Additional QRDA-Related Resources:

To find out more about QRDA and eCQMs, visit the Electronic Clinical Quality Improvement (eCQI) Resource Center.

For questions related to the QRDA IGs and/or Schematrons, visit the ONC Project Tracking System (Jira) QRDA project.