Follow-Up After Emergency Department Visit for People With High-Risk Multiple Chronic Conditions

Identifying Attributes

Care Settings
Care Transitions
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Pennsylvania Rural Health Model (PARHM)
Type of Quality Indicator
Process
IOM Quality Dimension
Effectiveness
Domain
Follow-Up

Defining Attributes

Definition

Percentage with follow-up after emergency department visit for people with high-risk multiple chronic conditions.

Numerator

A follow-up service within 7 days after the ED visit (8 total days)

Denominator

ED visits for Medicare beneficiaries ages 18 and older with multiple high-risk chronic conditions

Exclusions

Exclude ED visits followed by admission to an acute or non-acute inpatient care setting on date of the ED visit or w/in 7 days after the ED visit, regardless of the principal diagnosis for admission. To identify admissions to an acute or non-acute inpatient care setting: 1. Identify all acute&non-acute inpatient stays (Inpatient Stay Value Set). 2. Identify the admission date for the stay. An ED visit billed on the same claim as an inpatient stay is considered a visit that resulted in inpatient stay

Use of Risk Adjustment
No
Risk Adjustments

None

Stratifications

Collection and Reporting Attributes

Type of Data Collection
Administrative data
Data Collection Methods

Claims Data

Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods

Not publicly reported based on current evidence. Linked to payments

Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
No

Source and Reference Attributes

Technical Specifications
Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
No
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
Yes
Australian Consortium for Aged Care Endorsed
No
Can the Quality Indicator be Readily Implemented at a Population Level in Australia Given its Current Data Landscape?
No. Data exists but it is not routinely linked or cannot be linked.
Identified by PHARMA-Care Project
No
Upload Date
31 March 2026