Skip to main content

Emergency Department Use without Hospitalization During the First 60 Days of Home Health

CBE ID
0173
Endorsement Status
E&M Committee Rationale/Justification

Steward no longer seeking to maintain endorsement

1.1 New or Maintenance
Previous Endorsement Cycle
Is Under Review
No
1.3 Measure Description

Percentage of home health stays in which patients used the emergency department but were not admitted to the hospital during the 60 days following the start of the home health stay.

        • 1.5 Measure Type
          1.7 Electronic Clinical Quality Measure (eCQM)
          1.8 Level Of Analysis
          1.20 Testing Data Sources
        • 1.14 Numerator

          Number of home health stays for patients who have a Medicare claim for outpatient emergency department use and no claims for acute care hospitalization in the 60 days following the start of the home health stay.

        • 1.15 Denominator

          Number of home health stays that begin during the 12-month observation period.

        • Exclusions

          The following are excluded:

          1) Home health stays for patients who are not continuously enrolled in fee-for-service Medicare for the 60 days following the start of the home health stay or until death.
          2) Home health stays that begin with a Low Utilization Payment Adjustment (LUPA) claim. 
          3) Home health stays in which the patient receives service from multiple agencies during the first 60 days.
          4) Home health stays for patients who are not continuously enrolled in fee-for-service Medicare for the 6 months prior to the home health stay.

        • OLD 1.12 MAT output not attached
          Attached
          1.13a Data dictionary not attached
          No
        • Most Recent Endorsement Activity
          Endorsed All-Cause Admissions and Readmissions Project 2015-2017
          Initial Endorsement
          Last Updated
          Removal Date
        • Steward
          Centers for Medicare & Medicaid Services
          Steward Organization POC Email
              • Risk Adjustment
                Risk adjustment approach
                Off
                Risk adjustment approach
                Off
                Conceptual model for risk adjustment
                Off
                Conceptual model for risk adjustment
                Off