The measure estimates a hospital-level risk-standardized readmission rate (RSRR) following elective primary THA and/or TKA in Medicare Fee-For-Service (FFS) beneficiaries who are 65 years and older. The outcome (readmission) is defined as unplanned readmission for any cause within 30 days of the discharge date for the index admission (the admission included in the measure cohort). A specified set of planned readmissions do not count in the readmission outcome.
Measure Specs
General Information
Numerator
The outcome for this measure is 30-day readmissions. We define readmissions as inpatient admissions for any cause, with the exception of certain planned readmissions, within 30 days from the date of discharge of the index hospitalization. If a patient has more than one unplanned admission (for any reason) within 30 days after discharge from the index admission, only one is counted as a readmission. The measure looks for a dichotomous yes or no outcome of whether each admitted patient has an unplanned readmission within 30 days. However, if the first readmission after discharge is considered planned, any subsequent unplanned readmission is not counted as an outcome for that index admission, because the unplanned readmission could be related to care provided during the intervening planned readmission rather than during the index admission.
Denominator
The target population for the publicly reported measure includes admissions for Medicare FFS beneficiaries who are at least 65 years of age undergoing elective primary THA and/or TKA procedures.
Additional details are provided in S.9 Denominator Details.
Exclusions
The THA/TKA readmission measure excludes admissions for patients:
1. Without at least 30 days post-discharge enrollment in FFS Medicare;
2. Who were discharged against medical advice (AMA);
3. Admitted for the index procedure and subsequently transferred to another acute care facility;
4. Who had more than two THA/TKA procedure codes during the index hospitalization; or
5. Who had THA/TKA admissions within 30 days of a prior THA/TKA index admission.
Measure Calculation
Measure Record
Point of Contact
N/A
Public Comments