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

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

Steward no longer seeking to maintain endorsement

1.1 New or Maintenance
Maintenance
Is Under Review
No
Next Planned Maintenance Review
Fall 2023
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
      Outcome
      1.7 Electronic Clinical Quality Measure (eCQM)
      No
      1.8 Level Of Analysis
      Facility
      1.20 Testing Data Sources
      Claims Data
    • 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.

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