This facility-level measure estimates an all-cause, unplanned, 30-day, risk-standardized readmission rate for adult Medicare fee-for-service (FFS) patients with a principal discharge diagnosis of a psychiatric disorder or dementia/Alzheimer’s disease.
The performance period for the measure is 24 months.
- Measure TypeElectronic Clinical Quality Measure (eCQM)Level Of AnalysisCare SettingNumerator
The measure estimates the incidence of unplanned, all-cause readmissions to IPFs or short-stay acute care hospitals following discharge from an eligible IPF index admission. A readmission is defined as any admission that occurs within 3-30 days after the discharge date from an eligible index admission to an IPF, except those considered planned.
DenominatorThe target population for this measure is Medicare FFS beneficiaries discharged from an IPF with a principal diagnosis of a psychiatric disorder. A readmission within 30 days is eligible as an index admission, if it meets all other eligibility criteria.
ExclusionsThe measure excludes admissions for patients:
- Discharged against medical advice (AMA)
- With unreliable demographic and vital status data defined as the following:
o Age greater than 115 years
o Missing gender
o Discharge status of “dead” but with subsequent admissions
o Death date prior to admission date
o Death date within the admission and discharge dates but the discharge status was not “dead”
- With readmissions on the day of discharge or day following discharge because those readmissions are likely transfers to another inpatient facility. The hospital that discharges the patient to home or a non-acute care setting is accountable for subsequent readmissions.
- With readmissions two days following discharge because readmissions to the same IPF within two days of discharge are combined into the same claim as the index admission and do not appear as readmissions due to the interrupted stay billing policy. Therefore, complete data on readmissions within two days of discharge are not available.Testing Data Sources
- Measure StructureClinical Condition Topic AreaNon Condition SpecificTarget PopulationMeasure Selection AttributesNational Quality Strategy PrioritiesEffective Communication and Care Coordination
- Risk Adjustment
- Current or planned use(s)Current Use(s)
- Most Recent Endorsement ActivityEndorsed All-Cause Admissions and Readmissions Spring 2021Initial EndorsementNext Planned Maintenance ReviewAll-Cause Admissions and Readmissions Spring 2025Endorsement StatusLast Updated
- Steward Organization EmailSteward Organization Copyright
Not applicable