A number of quality metrics focused on neurological health care, including the Centers for Medicare & Medicaid Services (CMS) Star Ratings and Quality Indicators in Epilepsy Treatment Tool (QUIET), have been developed by various national organizations. The measures created by these health care quality entities focus on different aspects of population health management and vary in scope from process-related to clinically-focused metrics.

Quality Measures Relevant to Epilepsy

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About Centers for Medicare & Medicaid Services (CMS) Star Ratings
About QUIET Tool
Strategies for Improving Compliance5
In January 2011, the American Academy of Neurology published guidelines for quality improvement in follow-up visits for established epilepsy patients. The aim of these guidelines was to improve patient care in adult and pediatric epilepsy by improving consistency in follow-up care, including documentation.5

American Academy of Neurological Epilepsy Measures

Quality Measure
Review Frequency
Seizure type and current seizure frequency
All visits
Documentation of etiology of epilepsy or epilepsy syndrome
​All visits​
EEG results reviewed, requested, or ordered
Initial visit or if not done
MRI/CT scan reviewed, requested, or ordered
Initial visit or if not done
Querying and counseling about antiepileptic drug side effects
​All visits
Surgical therapy referral consideration for intractable epilepsy
Intractable patients every 3 years
Counseling about epilepsy specific safety issues
Counseling for women of childbearing potential with epilepsy
CT = computed tomography; EEG = electroencephalography; MRI = magnetic resonance imaging.
  1. Centers for Medicare & Medicaid Services. Part D Drugs and Formulary Requirements. In: Medicare Prescription Drug Benefit Manual. https://www.cms.gov/Medicare/Prescription-Drug-coverage/PrescriptionDrugCovContra/Downloads/Part-D-Benefits-Manual-Chapter-6.pdf. Accessed May 27, 2022.
  2. Centers for Medicare & Medicaid Services. 2017 Star Ratings Fact Sheet. https://www.cms.gov/newsroom/fact-sheets/2017-star-ratings. Accessed May 27, 2022.
  3. American Epilepsy Society. Quality Measures. https://www.aesnet.org/clinical_resources/practice_management/quality_measures. Accessed May 27, 2022.
  4. US Department of Veteran Affairs website. https://www.epilepsy.va.gov/quiet/. Accessed May 27, 2022.
  5. Nelson et al. Educational Intervention Improves Compliance With AAN Guidelines for Return Epilepsy Visits: A Quality Improvement Project. J Child Neurol. 2016;31:1320-1323.