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Care Coordination

Excess days in acute care (EDAC) after hospitalization for pneumonia

This measure assesses days spent in acute care within 30 days of discharge from an inpatient hospitalization for pneumonia, including aspiration pneumonia or for sepsis (not severe sepsis) with a secondary discharge diagnosis of pneumonia coded in the claim as present on admission (POA) and no secondary diagnosis of severe sepsis coded as POA.

CBE ID
2882

Family Evaluation of Hospice Care

Derived from responses to 17 items on the Family Evaluation of Hospice Care(FEHC)survey presented as a single score ranging from 0 to 100 and is an indication of the hospice´s overall performance on key aspects of care delivery.

CBE ID
0208

Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence

The percentage of emergency department (ED) visits for members 13 years of age and older with a principal diagnosis of alcohol or other drug (AOD) abuse or dependence, who had a follow up visit for AOD. Two rates are reported:
- The percentage of ED visits for which the member received follow-up within 30 days of the ED visit (31 total days).
- The percentage of ED visits for which the member received follow-up within 7 days of the ED visit (8 total days).

CBE ID
3488

Follow-Up After Emergency Department Visit for Mental Illness

The percentage of emergency department (ED) visits for members 6 years of age and older with a principal diagnosis of mental illness or intentional self-harm, who had a follow-up visit for mental illness. Two rates are reported:
- The percentage of ED visits for which the member received follow-up within 30 days of the ED visit (31 total days).
- The percentage of ED visits for which the member received follow-up within 7 days of the ED visit (8 total days).

CBE ID
3489

Follow-Up After Emergency Department Visit for Mental Illness or Alcohol and Other Drug Abuse or Dependence

The percentage of discharges for patients 18 years of age and older who had a visit to the emergency department with a primary diagnosis of mental health or alcohol or other drug dependence during the measurement year AND who had a follow-up visit with any provider with a corresponding primary diagnosis of mental health or alcohol or other drug dependence within 7- and 30-days of discharge.

Four rates are reported:
- The percentage of emergency department visits for mental health for which the patient received follow-up within 7 days of discharge.

CBE ID
2605

Follow-Up After Hospitalization for Mental Illness (FUH)

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.

CBE ID
0576

Functional Change: Change in Mobility Score

Change in rasch derived values of mobility function from admission to discharge among adults aged 18 and older receiving inpatient medical rehabilitation at a post acute care facility who were discharged alive. The timeframe for the measure is 12 months. The measure includes the following 4 mobility items:1. Transfer Bed/Chair/Wheelchair, 2. Transfer Toilet, 3. Locomotion, 4. Stairs.

CBE ID
2321

Functional Change: Change in Motor Score

Change in rasch derived values of motor function from admission to discharge among adult inpatient rehabilitation facility patients aged 18 years and older who were discharged alive. The timeframe for the measure is 12 months. The measure includes the following 12 FIM® items:Feeding, Grooming, Dressing Upper Body, Dressing Lower Body, Toileting, Bowel, Expression, Memory, Transfer Bed/Chair/Wheelchair, Transfer Toilet, Locomotion and Stairs.

CBE ID
2287

Functional Change: Change in Self Care Score

Change in rasch derived values of self-care function from admission to discharge among adults receiving inpatient medical rehabilitation and discharged alive. The timeframe for the measure is 12 months. The measure includes the following 8 items: Feeding, Grooming, Dressing Upper Body, Dressing Lower Body, Toileting, Bowel, Expression, and Memory.

CBE ID
2286