Early Live Discharges
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
The percentage of all live discharges from hospice occurring within the first 7 days after hospice admission.
Numerator
The total number of live discharges from the hospice occurring within the first seven days of hospice within a reporting period. Whether a live discharge occurs during the first seven days of hospice is assessed by looking at a patient's lifetime length of stay in hospice.
Claims-based calculation details: For each hospice, divide the number of live discharges in the first seven days of hospice by the number of live discharges.
Denominator
The total number of all live discharges from the hospice within a reporting period. Claims-based calculation details: Live discharges are assigned to a particular reporting period based on the date of the live discharge (which corresponds to the through date on the claim indicating the live discharge); Live discharges occur when the patient discharge status code on a hospice claim does not equal a value from the following list: "30", "40", "41", "42", "50", "51".
Exclusions
Use of Risk Adjustment
Risk Adjustments
None
Stratifications
None
Data Attributes
Type of Data Collection
Data Collection Methods
Data Source: Hospice Medicare claims data. Data are obtained from provider submitted claims for the information needed to calculate the measure, so providers do not submit any additional data to CMS. CMS will use 2 years of Medicare claims data (8 quarters) to calculate the measure. The ten indicators contribute to the HCI score as follows: Each HCI indicator has its own numerator, denominator, and resulting indicator score. A hospice's given indicator score relative to an Index Earned Point Criterion determines whether the hospice earns a point for that indicator towards the full index score; Index Earned Point Criteria were set based on CMS' statistical analysis of national hospice performance to ensure meaningful distinction between hospices; Hospices' HCI scores are calculated as the total number of Index Earned Points across the ten indicators and can range from a perfect 10 to a 0. All hospices with at least 20 claims during the sample period have indicator scores calculated.
Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
Public reporting.
Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
Source and Reference Attributes
Evidence Source
Hospice Care Index Technical Report: www.cms.gov/files/document/hospice-care-index-hci-technical-reportjuly-2022.pdf. Date cited 12/10/23. CMS Current Measures: www.cms.gov/medicare/quality/hospice/current-measures. Date cited 12/10/23.
Technical Specifications
Link to Measurement Tools
This measure is linked to the Hospice Care Index (HCI) measure.