Contraceptive Use eCQMs
The Contraceptive Use electronic clinical quality measures (CU-SINC eCQMs) of contraceptive provision are a set of performance measures derived from standardized data elements in electronic health records (EHR). These eCQMs calculate the percentage of people who receive or were documented to be using most or moderately effective method of contraception, and who received a Long-Acting Reversible Contraceptive (LARC) method specifically, among those who self-identify their need for contraceptive services (i.e. indicate “yes” to the SINC screening question) in a given facility. The CU-SINC eCQMs can assess access to contraception services in a given facility or plan and can provide an opportunity to have public reporting and quality improvement around meeting people’s contraceptive needs.
 
The Contraceptive Use eCQMs measure the following:
 

Non-postpartum measure

Primary measure: Eligible women who received or were documented to be using a most (i.e., sterilization, implants, intrauterine devices or systems (IUD/IUS) or moderately effective (i.e., injectables, oral pills, patch, or ring) contraceptive method. 

Sub-measure: Eligible women provided a long-acting reversible contraceptive method (IUD or implant).  

Inclusion criteria: All women 15 – 44 years of age with a visit in a one year period who indicated an interest in contraception

Postpartum measure

Primary measure: All eligible patients who received a most or moderately effective method in the postpartum period

Sub-measure: Of eligible patients, those who received a long-acting reversible contraceptive method (intrauterine device or implant) during the postpartum period.

Inclusion criteria: All women 15 – 44 who had a live birth in the measurement year, excluding those who had a live birth in the last two months of the measurement year because they have not had time to receive a method

 
A diagram of a diagramDescription automatically generated with medium confidence
Figure: specifications for defining inclusion in the numerator and denominator of the Contraceptive Use eCQMs
 
Why are Contraceptive Use eCQMs needed? 

Alternative measures capturing contraceptive access and provision utilize claims-based measures. However, claims data do not always accurately identify which contraceptive method a person is using following a visit. Claims-based measures also do not define the population of interest for the measure, as they cannot accurately parse out which patients are in need of contraceptive services.  

The Contraceptive Use eCQMs address these issues by: 1) more accurately documenting contraceptive use and 2) more accurately defining the denominator of who is in need of contraceptive services, using the SINC screening question. Defining the denominator in this way guards against the possibility of directive or coercive counseling towards contraception that may be an unintentional result of the measure, which is particularly important given the (ongoing) history of reproductive oppression, contraceptive coercion, and biased counseling in the United States directed at women of color and low-income women. 

Additionally, claims-based measures can only be used in systems with a fee-for-services model. Electronic measures can also be used in a wider array of settings, including systems using prospective payment systems under Medicaid policy, such as Federally Qualified health Centers and other community health centers. 

The Contraceptive Use eCQMs (formerly SINC-based eCQMs) were endorsed by the National Quality Forum in spring 2022 and re-endorsed by the Partnership for Quality Measures in 2023.  Visit the PQM webpage on SINC-based eCQMs specifications for more information on the Contraceptive Use eCQMs, including the full specifications.