CMS and CDC align on FHIR hypoglycemia measures; CMS weighs NHSN reporting pathway to reduce burden
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Summary
CMS detailed a collaboration with CDC (NHSN) to align severe hypoglycemia digital quality measures for inpatient settings and said CMS may allow hospitals to report via the NHSN FHIR pathway to reduce provider burden and support surveillance.
During the DQM public comment webinar, Joel Andres of CMS highlighted an early collaboration with the Centers for Disease Control and Prevention to modernize hypoglycemia quality measurement via FHIR. The two agencies have produced aligned measures for severe hypoglycemia and CMS is considering reporting options that would allow hospitals to submit some measures using the NHSN FHIR pathway.
"CMS and CDC recognize an opportunity to collaborate and consider possible reporting avenues that would permit automated reporting of a single set of data to serve the needs of both programs," Joel Andres said, noting this alignment could reduce reporting burden while still meeting NHSN surveillance needs.
Joel described technical differences between the measures: the CMS hypoglycemia DQM uses 16 laboratory concepts to identify blood glucose tests and 92 RxNorm medication concepts for antidiabetic drugs; the NHSN version uses a broader set of concept lists (84 lab concepts and an expanded medication list) to maximize surveillance capture. CMS said both measures apply to inpatient encounters (including emergency department and observation encounters as inpatient) and capture events occurring within one hour of inpatient admission over a one‑year measurement period.
CMS and CDC are soliciting feedback on the alignment and on whether one or both measures should be used within their respective reporting programs. Reviewers were asked to consider the adequacy of code lists, timing and boundary scenarios in test cases, and the implications for hospital reporting workflows.
Next steps: reviewers should check the NHSN DQM implementation guide and the CMS JIRA tickets for measure details and submit comments on the relevant ONC JIRA tickets by Feb. 23, 2026.