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Risk-Standardized Acute Admission Rates for Patients with Heart Failure

CBE ID
2886
Endorsement Status
1.0 New or Maintenance
1.1 Measure Structure
Previous Endorsement Cycle
Is Under Review
No
1.6 Measure Description

Rate of risk-standardized acute, unplanned hospital admissions among Medicare fee-for-service (FFS) beneficiaries 65 years and older with heart failure who are assigned to an Accountable Care Organization (ACO).

    Measure Specs
      General Information
      1.7 Measure Type
      1.3 Electronic Clinical Quality Measure (eCQM)
      1.8 Level of Analysis
      1.9 Care Setting
      1.20 Types of Data Sources
      1.14 Numerator

      The outcome for this measure is the number of acute unplanned admissions per 100 person-years at risk for admission. Persons are considered at risk for admission if they are alive, enrolled in Medicare FFS, and not currently admitted to an acute care hospital. (See S.5, Numerator Details, for more information.)

      1.15 Denominator

      The target population is ambulatory Medicare FFS beneficiaries aged 65 years and older assigned to the ACO with a diagnosis of heart failure.

      Exclusions

      The measure excludes:

      1. Patients with left ventricular assist devices (LVADs).

      2. Beneficiaries who are alive during the measurement year and do not have 12 months of continuous enrollment in Medicare Part A during the measurement year, or beneficiaries who die during the measurement year and are not continuously enrolled for the time period up until their date of death.

      Most Recent Endorsement Activity
      Measure Retired and Endorsement Removed All-Cause Admissions and Readmissions Spring Cycle 2020
      Initial Endorsement
      Last Updated
      Removal Date
      Steward Organization
      Centers for Medicare & Medicaid Services
      Steward POC email
      Vinitha.meyyur@cms.hhs.gov
      Steward Organization Copyright

      Not applicable.

              Risk Adjustment
                Use
                Planned Use
                6.1.2 Current or Planned Use(s)
                  Public Comments