Populations at Risk

This measure estimates a hospital-level 30-day, all-cause, risk-standardized mortality rate (RSMR) for patients discharged from the hospital with a principal discharge diagnosis of acute myocardial infarction (AMI). The outcome is all-cause 30-day mortality, defined as death from any cause within 30 days of the index admission date, including in-hospital death, for AMI patients. The target population is Medicare Fee-for-Service beneficiaries who are 65 years or older.

Iatrogenic pneumothorax cases (secondary diagnosis) per 1,000 surgical and medical discharges for patients ages 18 years and older. Excludes cases with chest trauma, pleural effusion, thoracic surgery, lung or pleural biopsy, diaphragmatic repair, or cardiac procedures; cases with a principal diagnosis of iatrogenic pneumothorax; cases with a secondary diagnosis of iatrogenic pneumothorax present on admission; and obstetric cases.

Proportion of adult patients with a new CIED with an in-person evaluation within 2 to 12 weeks following implantation.

Inpatients age 6 months and older discharged during October, November, December, January, February or March who are screened for influenza vaccine status and vaccinated prior to discharge if indicated.

Percentage of end stage renal disease (ESRD) patients aged 6 months and older receiving hemodialysis or peritoneal dialysis during the time from October 1 (or when the influenza vaccine became available) to March 31 who either received, were offered and declined, or were determined to have a medical contraindication to the influenza vaccine.

The measure is derived from patient responses to the Hip or Knee Decision Quality Instruments. Participants who have a passing knowledge score (60% or higher) and a clear preference for surgery are considered to have met the criteria for an informed, patient-centered decision.
The target population is adult patients who had a primary hip or knee replacement surgery for treatment of hip or knee osteoarthritis.

This measure assesses the degree to which the organization initiates and engages members identified with a need for alcohol and other drug (AOD) abuse and dependence services and the degree to which members initiate and continue treatment once the need has been identified. Two rates are reported:

Percentage of episodes with an International Normalized Ratio (INR) test performed three to seven days after a newly started interacting anti-infective medication for individuals receiving warfarin

Percentage of individuals at least 18 years of age as of the end of the measurement period with at least 56 days of warfarin therapy who receive at least one International Normalized Ratio (INR) test during each 56-day interval with active warfarin therapy.

Percentage of adult inpatient hospital discharges to home for which the individual was on warfarin and discharged with a non-therapeutic International Normalized Ratio (INR) who had an INR test within 14 days of hospital discharge