Daily Practice


Quality Measurement

Quality measures are used to assess various aspects of the delivery of healthcare and are directly linked to physician payment through a variety of quality reporting programs. ASTRO is committed to developing quality measures that are meaningful and relevant to radiation oncologists through independent development efforts, and by working collaboratively with other medical societies. See a full list of ASTRO's quality measures.

Measures Governance

Measure development at ASTRO operates under the Clinical Affairs and Quality Council (CAQC). The mission is to identify quality indicators and develop measures to address gaps in care and variation in treatment; to provide oversight on the use of measures in ASTRO programs and make recommendations about the use of measures in federal programs; to evaluate and make recommendations about the maintenance of measures; and to represent ASTRO before quality measurement and improvement organizations.

The measures developers assess clinical practice statements for measure development using standardized evaluation criteria. Measure concepts are vetted, prioritized and tested according to clinical importance, comprehensiveness and reliability and feasibility of reporting.

In light of the evolving measurement landscape and the recent changes in Medicare payments to physicians, there is a need for a strategic shift in ASTRO’s measure development approach. With the sustainable growth rate (SGR) formula permanently repealed, Medicare has replaced its multiple quality reporting programs with a new single program called Merit-based Incentive Payment System (MIPS).

MIPS consolidated and replaced existing incentive programs such as physician quality reporting system (PQRS), value-based payment modifier (VBM) and electronic health records/meaningful use (MU). CMS has created a plan for development of new quality measures that prioritizes outcome, patient experience, care coordination and appropriate use measures. 

The shifts in Medicare quality reporting programs presents an opportunity for ASTRO to revisit and refine its measures development and implementation processes. Subsequently there is an urgency to develop robust sets of measures that will satisfy both quality improvement and public reporting/accountability needs.

Moving forward, ASTRO’s overall strategy will focus efforts on developing palliative care measure specifications; developing specifications for broadly applicable measures; and developing cancer site-specific measures including lung, breast, prostate, gastrointestinal, central nervous system and head and neck. This effort will include a timeline from measure development to roll-out depending on the measure complexity, type and reporting. 

Relationships with External Stakeholders

ASTRO works closely with the Physician Consortium for Performance Improvement (PCPI) and the National Quality Forum (NQF), and also works collaboratively with other medical specialty societies to further its measure development efforts, as noted below:


  • PCPI is a national, physician-led organization dedicated to enhancing quality and patient safety.
  • ASTRO has developed 15 quality measures in collaboration with other medical societies, which were approved by PCPI in 2007.
  • PCPI assists ASTRO in measure stewardship and maintenance efforts.

Medical Societies

  • ASTRO is currently working with the American Society of Clinical Oncology (ASCO) on cross-cutting measure development for utilization by both organizations in various quality programs and reporting environments.
  • ASTRO has previously engaged in collaborative measure development efforts with ASCO and the Society for Surgical Oncology (SSO) to address interdisciplinary coordinated care.  This project is a direct result of a collaborative measure summit convened at the ASCO 2012 Quality Care Symposium.
  • ASTRO and AUA collaborate together on the stewardship of prostate cancer measures.


  Last Updated January 29, 2018