PQA convenes two standing technical expert panels – the Quality Metrics Expert Panel (QMEP) and Measure Update Panel (MUP) – to support PQA’s systematic, transparent, and consensus-based process for measure development and maintenance.
Each nomination-based panel consists of approximately 25 individuals representing PQA’s multistakeholder membership and other subject matter experts, including patients, caregivers, and patient advocates.
The QMEP assesses measures in development and recommended updates to endorsed measures against standard measure criteria, makes final recommendations to PQA regarding measure endorsement or retirement consideration, and makes final recommendations to PQA staff for measure development discontinuation.
The MUP reviews potential updates to PQA-endorsed measures to ensure that measure updates reflect current evidence and align with standard measure criteria. Recommendations from the MUP, including potential measure updates or retirement considerations, then move forward to the QMEP for review.
Both panels met several times in 2025, and this blog provides a brief recap of their discussions and recommendations.
New PQA measure advanced for endorsement consideration
Early in 2025, the QMEP reviewed a new health plan measure, Chronic Obstructive Pulmonary Disease Treatment Ratio (CTR), that evaluates the percentage of individuals 40 years of age or older whose Chronic Obstructive Pulmonary Disease (COPD) Treatment Ratio (CTR) was ≥0.7 during the treatment period. The panel voted unanimously to advance the CTR measure to PQA members for endorsement consideration after reviewing the measure’s evidence and rationale, specifications, and testing results against the standard measure criteria of importance, scientific acceptability, feasibility, and usability. PQA members endorsed the CTR measure after a public comment period.
Updates to PQA-endorsed measures
As a measure steward, PQA conducts continuous evaluation to ensure that PQA measures remain current, appropriate and impactful in light of new medications, changing indications, and the emergence of new clinical evidence or standards.
The MUP and QMEP discussed two proposed updates to Antipsychotic Use in Persons with Dementia (APD), a PQA-endorsed health plan measure that evaluates the percentage of individuals ≥65 years of age with dementia who received an antipsychotic medication without evidence of an appropriate indication for antipsychotic use. The panel considered removal of brexpiprazole from the measure due to an FDA-approved indication for treatment of agitation associated with dementia due to Alzheimer’s disease.
At a later meeting, the panels discussed expanding the eligible population criteria for APD to include individuals with ≥2 prescription claims for self-administered subcutaneous lecanemab-irmb, a newly approved product indicated for the treatment of Alzheimer’s disease.
These changes to APD were unanimously approved by the panels and will be reflected, respectively, in the February 2026 PQA Measure Manual and February 2027 PQA Measure Manual.
The MUP and QMEP additionally discussed a proposed update to Use of Opioids at High Dosage in Persons Without Cancer (OHD), a PQA-endorsed health plan measure that evaluates the percentage of individuals ≥18 years of age who received prescriptions for opioids with an average daily dosage of ≥90 morphine milligram equivalents (MME) over a period of ≥90 days. The panels recommended updating the daily MME calculation methodology to align with the 2022 Centers for Disease Control and Prevention (CDC) Clinical Practice Guideline for Prescribing Opioids for Pain and the Medicare Part D Overutilization Monitoring System (OMS). Further, the MME conversion factors for four opioids (hydromorphone, methadone, tramadol, and transdermal fentanyl) were updated to align with these resources.
This update to OHD was approved unanimously by the MUP and QMEP and will be included in the February 2026 PQA Measure Manual.
Additional Changes to PQA Measures
The MUP and QMEP are informed of changes to PQA measures that are considered straightforward and non-material, without significant, if any, impact on measure calculation. For example, the addition of a new drug in a pharmacologic or therapeutic class that is already targeted in a measure is considered a non-material change. This type of change does not require a panel vote.
Ocrelizumab/hyaluronidase-ocsq, an anti-CD20 monoclonal antibody, will be added to the Adherence to Non-Infused Disease-Modifying Agents Used to Treat Multiple Sclerosis (PDC-MS) measure as an exclusion beginning with the February 2026 PQA Measure Manual. Telmisartan/amlodipine/indapamide, a combination product that includes an angiotensin II receptor blocker, calcium channel blocker, and thiazide-like diuretic, will be added upon market availability to five relevant medication tables across five PQA measures that currently include telmisartan, amlodipine, or related combination products.
Get Engaged with PQA’s Measure Process
Register to attend the Q2 2026 PQA Member Webinar on April 29 for more information on the MUP and PQA’s quality measurement and research work. Registration information can be found in the Member Resources Library. Learn about the PQA Measure Life Cycle and how PQA develops, tests and maintains measures.