Physician Value-Based Payment Modifier (VBM)

For both the 2018 claims and registry specifications AND the 2019 performance period eMeasure (v8) the measure description is as follows:

Percentage of patients aged 40 years and older with an emergency department discharge diagnosis of non-traumatic chest pain who had a 12-lead electrocardiogram (ECG) performed

This is a clinical process measure that assesses falls prevention in older adults. The measure has three rates:

A) Screening for Future Fall Risk:
Percentage of patients aged 65 years and older who were screened for future fall risk at least once within 12 months



B) Falls Risk Assessment: 
Percentage of patients aged 65 years and older with a history of falls who had a risk assessment for falls completed within 12 months

C) Plan of Care for Falls: 

The percentage of discharges for members 6 years of age and older who were hospitalized for treatment of selected mental illness or intentional self-harm diagnoses and who had a follow-up visit with a mental health provider. Two rates are reported:
1. The percentage of discharges for which the member received follow-up within 30 days after discharge.
2. The percentage of discharges for which the member received follow-up within 7 days after discharge.

Percentage of children newly prescribed attention-deficit/hyperactivity disorder (ADHD) medication who had at least three follow-up care visits within a 10-month period, one of which is within 30 days of when the first ADHD medication was dispensed.
An Initiation Phase Rate and Continuation and Maintenance Phase Rate are reported.

Percentage of visits for patients aged 18 years and older with documentation of a current functional outcome assessment using a standardized functional outcome assessment tool on the date of the encounter AND documentation of a care plan based on identified functional outcome deficiencies on the date of the identified deficiencies

A self-report outcome measure of functional status for patients 14 years+ with elbow, wrist, hand impairments. The change in functional status assessed using FOTO (elbow, wrist and hand) PROM is adjusted to patient characteristics known to be associated with functional status outcomes (risk adjusted) and used as a performance measure at the patient level, at the individual clinician, and at the clinic level to assess quality.

This is a patient-reported outcome performance measure (PRO-PM) consisting of an item response theory-based patient-reported outcome measure (PROM) of change in functional status (FS) for patients aged 14 years and older with foot and ankle impairments. The change in FS is assessed using the FOTO Lower Extremity Physical Function (LEPF) PROM. The measure is adjusted to patient characteristics known to be associated with FS outcomes (risk adjusted) and used as a performance measure at the patient, individual clinician, and clinic levels to assess quality.

A self-report outcome measure of functional status for patients 14 years+ with general orthopaedic impairments. The change in functional status assessed using FOTO (general orthopedic) PROM is adjusted to patient characteristics known to be associated with functional status outcomes (risk adjusted) and used as a performance measure at the patient level, at the individual clinician, and at the clinic level by to assess quality.

A self-report measure of change in functional status for patients 14 years+ with hip impairments. The change in functional status assessed using FOTO’s (hip) PROM is adjusted to patient characteristics known to be associated with functional status outcomes (risk adjusted) and used as a performance measure at the patient level, at the individual clinician, and at the clinic level to assess quality.