The Standardized Emergency Department Encounter Ratio is defined to be the ratio of the observed number of emergency department (ED) encounters that occur for adult Medicare ESRD dialysis patients treated at a particular facility to the number of encounters that would be expected given the characteristics of the dialysis facility’s patients and the national norm for dialysis facilities. Note that in this document an “emergency department encounter” always refers to an outpatient encounter that does not end in a hospital admission. This measure is calculated as a ratio but can also be expressed as a rate.
When used for public reporting, the measure calculation will be restricted to facilities with greater than 5 patient years at risk in the reporting year. This restriction is required to ensure patients cannot be identified due to small cell size.
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1.5 Measure Type1.7 Electronic Clinical Quality Measure (eCQM)1.8 Level Of Analysis1.9 Care Setting1.20 Testing Data Sources
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1.14 Numerator
The observed number of outpatient Emergency Department encounters during the reporting period among eligible adult Medicare patients at a facility.
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1.15 Denominator
The expected number of Emergency Department encounters among eligible Medicare patients at the facility during the reporting period adjusted for the characteristics of the patients at the facility.
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Exclusions
Exclusions that are implicit in the denominator definition include time at risk while a patient:
• Has Medicare Advantage coverage
• Has had ESRD for 90 days or less
• Is less than 18 years of age
The denominator also excludes patient time at risk for calendar months in which a patient is:
• Actively enrolled in hospice at any time during the calendar month
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OLD 1.12 MAT output not attachedAttached
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Most Recent Endorsement ActivityEndorsed All-Cause Admissions and Readmissions Spring Cycle 2020Initial EndorsementLast Updated
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StewardCenters for Medicare & Medicaid ServicesSteward Organization POC Email
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Risk AdjustmentRisk adjustment approachOffRisk adjustment approachOffConceptual model for risk adjustmentOffConceptual model for risk adjustmentOff
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6.1.3 Current Use(s)
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