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Stratification by risk category/subgroup

Functional Communicaton Measure: Attention

This measure describes the change in functional communication status subsequent to speech-language pathology treatment of patients who have attention deficits.

CBE ID
0449

Functional Communicaton Measure: Reading

This measure describes the change in functional communication status subsequent to speech-language pathology treatment of patients with reading disorders.

CBE ID
0446

Functional Communicaton Measure: Swallowing

This measure describes the change in functional communication status subsequent to speech-language pathology treatment of patients who exhibit difficuty in swallowing.

CBE ID
0443

Glycemic Control - Hyperglycemia

Average percentage of hyperglycemic hospital days for individuals with a diagnosis of diabetes mellitus, anti-diabetic drugs (except metformin) administered, or at least one elevated glucose level during the hospital stay

CBE ID
2362e

Knee Arthroplasty

The Knee Arthroplasty 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 30 days prior to the clinical event that opens or ‘triggers’ the episode, through 90 days after the trigger.

CBE ID
3512

Late HIV diagnosis

Percentage of persons 13 years and older diagnosed with Stage 3 HIV infection (AIDS) within 3 months of a diagnosis of HIV infection.

CBE ID
1999

Low Birth Weight Rate (PQI 9)

Low birth weight (< 2,500 grams) infants per 1,000 newborns. Excludes transfers from other institutions.

[NOTE: The software provides the rate per newborn. However, common practice reports the measure as per 1,000 newborns. The user must multiply the rate obtained from the software by 1,000 to report admissions per 1,000 newborns.]

[NOTE: This indicator can be calculated in SAS QI Software Version 4.5 using either the PDI Module or the PQI #9 Standalone Module.]

CBE ID
0278

Lumbar Spine Fusion for Degenerative Disease, 1-3 Levels Measure

The Lumbar Spine Fusion for Degenerative Disease, 1-3 Levels episode-based cost measure evaluates a clinician’s risk-adjusted cost to Medicare for patients who undergo surgery for lumbar spine fusion during the performance period. The measure score is the clinician’s risk-adjusted cost for the episode group averaged across all episodes attributed to the clinician.

CBE ID
3626

Medicare Spending Per Beneficiary (MSPB) - Hospital

The MSPB Hospital measure evaluates hospitals’ risk-adjusted episode costs relative to the risk-adjusted episode costs of the national median hospital. Specifically, the MSPB Hospital measure assesses the cost to Medicare for Part A and Part B services performed by hospitals and other healthcare providers during an MSPB Hospital episode, which is comprised of the periods 3-days prior to, during, and 30-days following a patient’s hospital stay. The MSPB Hospital measure is not condition specific and uses standardized prices when measuring costs.

CBE ID
2158

Non-Emergent Coronary Artery Bypass Graft (CABG) Measure

The Non-Emergent CABG episode-based cost measure evaluates a clinician’s risk-adjusted cost to Medicare for patients who undergo a CABG procedure during the performance period. The measure score is the clinician’s 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 each episode from 30 days prior to the clinical event that opens, or “triggers,” the episode through 90 days after the trigger.

CBE ID
3625