Early Live Discharges

Identifying Attributes

Care Settings
Palliative Care
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Hospice Quality Reporting Program
Type of Quality Indicator
Outcome
IOM Quality Dimension
Effectiveness
Domain
Care of the Patient at the End of Life

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
No
Risk Adjustments

None

Stratifications

None

Data Attributes

Type of Data Collection
Administrative data
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
Continuous
Frequency of Data Collection in Days
1
Reporting Methods

Public reporting.

Reporting Frequency
Annually
Reporting Frequency in Days
365
Indicator Has Recommended Targets
Yes

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.

Link to Measurement Tools

This measure is linked to the Hospice Care Index (HCI) measure.

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
Yes
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
Identified by PHARMA-Care Project
No
Upload Date
12 March 2025