The percentage of issuer-product-level acute events requiring either an emergency department (ED) visit or hospitalization for one of the following 6 chronic conditions: hypertension, asthma, heart failure (HF), coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), or diabetes mellitus (Type I or Type II), where follow-up was received within the timeframe recommended by clinical practice guidelines in a non-emergency outpatient setting.
- Measure TypeElectronic Clinical Quality Measure (eCQM)Level Of AnalysisMAT output not attachedAttachedNumerator
The numerator is the sum of the issuer-product-level denominator events (Emergency Room [ED], observation hospital stay or inpatient hospital stay) for acute exacerbation of hypertension, asthma, heart failure (HF), coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), or diabetes where follow-up was received within the timeframe recommended by clinical practice guidelines, as detailed below:
• Hypertension: Within 7 days of the date of discharge
• Asthma: Within 14 days of the date of discharge
• HF: Within 14 days of the date of discharge
• CAD: Within 14 days of the date of discharge
• COPD: Within 30 days of the date of discharge
• Diabetes: Within 30 days of the date of dischargeDenominatorThe denominator is the sum of the plan-product-level acute exacerbations that require either an ED visit, observation stay, or inpatient stay (i.e., acute events) for any of the six conditions listed above (hypertension, asthma, HF, CAD, COPD, or diabetes).
ExclusionsThe measure excludes events with:
1. Subsequent acute events that occur two days after the prior discharge, but still during the follow-up interval of the prior event for the same reason. To prevent double-counting, only the first acute event will be included in the denominator.
2. Acute events after which the patient does not have continuous enrollment for 30 days in the same product.
3. Acute events where the discharge status of the last claim is not “to community” (“Left against medical advice” is not a discharge to community.)
4. Acute events for which the calendar year ends before the follow-up window ends (e.g., acute asthma events ending fewer than 14 days before December 31)
5. Acute events where the patient enters a skilled nursing facility (SNF), non-acute care, or hospice care within the follow-up intervalAll information required to stratify the measure resultsOffAll information required to stratify the measure resultsOffTesting Data Sources
- Measure StructureMeasure Selection AttributesNational Quality Strategy PrioritiesPatient ExperiencePerson- and Family-Centered Care
- Risk AdjustmentRisk adjustment approachOffRisk adjustment approachOffConceptual model for risk adjustmentOffConceptual model for risk adjustmentOff
- Current or planned use(s)Current Use(s)Planned Use
- Most Recent Endorsement ActivityEndorsed Patient Experience and Function Fall Cycle 2018Initial EndorsementNext Planned Maintenance ReviewSpring 2024Endorsement StatusLast Updated
- Do you have a secondary measure developer point of contact?OnMeasure Developer Secondary Point Of Contact
Rachel Johnson-DeRycke
United StatesMeasure Developer Secondary Point Of Contact EmailMeasure Developer Secondary Point Of Contact Phone NumberThe measure developer is NOT the same as measure stewardOnSteward Organization EmailSteward Phone NumberSteward AddressTeresa Winder-Wells
United StatesSteward Organization URLSteward Organization CopyrightNot applicable
- Detailed Measure SpecificationsNoLogic ModelOffImpact and GapNoFeasibility assessment methodology and resultsNoAddress health equityNoMeasure’s use or intended useNo508 ComplianceOffIf no, attest that all information will be provided in other fields in the submission.Off