42 CFR 414.1260
§ 414.1260 Composite scores.
United States · 42 CFR — Public Health · Status: effective
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- Citation
- 42 CFR 414.1260, § 414.1260 Composite scores, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/203995
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Full text
(a)(1) The standardized score for each quality of care measure is classified into one of the following equally weighted domains to determine the quality composite:
(i) Patient safety.
(ii) Patient experience.
(iii) Care coordination.
(iv) Clinical care.
(v) Population/community health.
(vi) Efficiency.
(2) If a domain includes no measure or does not reach the minimum case size in § 414.1265, the remaining domains are equally weighted to form the quality of care composite.
(b)(1) The standardized score for each cost measure is grouped into two separate and equally weighted domains to determine the cost composite:
(i) Total per capita costs for all attributed beneficiaries: Total per capita costs measure and Medicare Spending per Beneficiary measure; and
(ii) Total per capita costs for all attributed beneficiaries with specific conditions: Diabetes, coronary artery disease, chronic obstructive pulmonary disease, or heart failure (four measures).
(2) Measures within each domain are equally weighted.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.