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Spring 2019

Proportion of Days Covered (PDC): 3 Rates by Therapeutic Category

  • The percentage of individuals 18 years and older who met the Proportion of Days Covered (PDC) threshold of 80 percent during the measurement year.

    Report a rate for each of the following:
    • Diabetes All Class (PDC-DR)
    • Renin Angiotensin System Antagonists (PDC-RASA)
    • Statins (PDC-STA)

    A higher rate indicates better performance.

    CBE ID
    0541

Rheumatoid Arthritis: Assessment of Disease Activity

  • Percentage of patients 18 years and older with a diagnosis of rheumatoid arthritis and >=50% of total number of outpatient RA encounters in the measurement year with assessment of disease activity using a standardized measure.

    CBE ID
    2523

Risk-Adjusted Operative Mortality for Pediatric and Congenital Heart Surgery

  • Risk-adjusted percent of patients undergoing index pediatric and/or congenital heart surgery who die, including both 1) all deaths occurring during the hospitalization in which the procedure was performed, even if after 30 days (including patients transferred to other acute care facilities), and 2) those deaths occurring after discharge from the hospital, but within 30 days of the procedure

    CBE ID
    2683

Risk-standardized complication rate (RSCR) following elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA) for Merit-based Incentive Payment System (MIPS) Eligible Clinicians and Eligible Clinician Groups

  • This measure is a re-specified version of the measure, “Hospital-level risk-standardized complication rate (RSCR) following elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA)” (NQF 1550), which was developed for patients 65 years and older using Medicare claims data.

    CBE ID
    3493

Routine Cataract Removal with Intraocular Lens (IOL) Implantation

  • The Routine Cataract Removal with Intraocular Lens (IOL) Implantation cost measure evaluates clinicians’ risk-adjusted cost to Medicare for beneficiaries who receive this procedure. The cost measure score is a clinician’s average risk-adjusted cost for the episode group averaged across all episodes attributed to the clinician. This procedural measure includes costs of services that are clinically related to the attributed clinician’s role in managing care during the 60 days prior to the clinical event that opens or ‘triggers’ the episode, through 90 days after the trigger.

    CBE ID
    3509

Screening/Surveillance Colonoscopy

  • The Screening/Surveillance Colonoscopy cost measure evaluates clinicians’ risk-adjusted cost to Medicare for beneficiaries who receive this procedure. The cost measure score is a clinician’s average risk-adjusted cost for the episode group averaged across all episodes attributed to the clinician. This procedural measure includes costs of services that are clinically related to the attributed clinician’s role in managing care from the day of the clinical event that opens or ‘triggers’ the episode, through 14 days after the trigger.

    CBE ID
    3510