Percentage of emergency department visits for members 18 years and older with multiple high-risk chronic conditions who had a follow-up service within 7 days of the Emergency Department visit.

Number in the denominator with a follow-up service within 7 days after the Emergency Department visit (8 total days).

Number of Emergency Department for Medicare beneficiaries ages 18 and older with multiple high-risk chronic conditions. Eligible members must have two or more of the following chronic conditions: COPD; Alzheimer's disease and related disorders; chronic kidney disease; depression; heart failure; acute myocardial infarction; atrial fibrillation; and stroke and transient ischaemic attack.

Emergency Department visits followed by admission to an acute or non-acute inpatient care setting on the date of the Emergency Department visit or within 7 days after the Emergency Department visit, regardless of the principal diagnosis for admission (excluded from the measure because admission to an acute or non-acute setting may prevent an outpatient follow-up visit from taking place).

None

Health and Drug Plans.

NCQA website - National averages (Publicly available) hhttps://web.archive.org/web/20241212044218/https://www.ncqa.org/hedis/measures/follow-up-after-emergency-department-visit-for-people-with-high-risk-multiple-chronic-conditions/

Kranz AM, DeYoreo M, Eshete-Roesler B, Damberg CL, Totten M, Escarce JJ, Timbie JW. Health system affiliation of physician organizations and quality of care for Medicare beneficiaries who have high needs. Health Serv Res. 2020 Dec;55 Suppl 3(Suppl 3):1118-1128. doi: 10.1111/1475-6773.13570. Epub 2020 Oct 6. PMID: 33020920; PMCID: PMC7720706. web.archive.org/web/20241212044218/https://www.ncqa.org/hedis/measures/follow-up-after-emergency-department-visit-for-people-with-high-risk-multiple-chronic-conditions/ cmit.cms.gov/cmit/#/MeasureView/?variantId=5196&sectionNumber=1 www.cms.gov/medicare/health-drug-plans/part-c-d-performance-data

Medicare 2023 Part C & Display Measure Technical Notes page 9 www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/PerformanceData