The percentage of patients aged 18 years and older who had an ambulatory palliative care visit and report getting the help they wanted for their pain from their palliative care provider and team within 6 months of the ambulatory palliative care visit.

The number of patients aged 18 years and older who report getting the help they wanted for their pain from their palliative care provider and team within 6 months of an ambulatory palliative care visit. The Receiving Desired Help for Pain measure is composed of a single data element: In the last 6 months, did you get as much help as you wanted for your pain from this provider and team?

All patients aged 18 years and older who had an ambulatory palliative care visit. Ambulatory palliative care visit defined as ICD-10 Z51.5 (Encounter for Palliative Care), OR Provider Hospice and Palliative Care Specialty Code 17; AND CPT 99201-99205 (New Office Visit); OR CPT 99211-99215 (Established Office Visit); or Place of service (POS) Code 11 – Office.

Denominator Exclusions: Patients who do not complete and return the patient experience survey within 6 months of the eligible ambulatory palliative care visit; Patients who respond on the patient experience survey that they did not receive care by the listed ambulatory palliative care provider in the last six months (disavowal); Patients who were determined to be deceased when the survey reached them; Patients for whom a proxy completed the entire survey on their behalf for any reason (no patient involvement); Patients who respond "No" to the questions "In the last 6 months, have you ever had pain?" OR "In the last 6 months, did you want help from this provider and team for this pain?"; Patients who have died or are unable to complete the patient experience survey due to cognitive impairment will be excluded. Proxy assistance with the survey is allowed; however, following discussion with the project advisory board, we decided to exclude surveys that were completed solely by a proxy with no patient involvement for conceptual reasons.

Statistical risk model. Risk adjustment calculation (to be performed by CMS or its third-party intermediary) is used to estimate risk-adjusted program level measure scores, we utilise hierarchical generalised-linear models that relate the proportion of patients responding "Yes, definitely" on the Receiving Help for Pain question to program scores, conditioned on risk adjustment covariates (survey mode and proxy assistance).

None

Data sources: Patient medical records (paper-based or electronic) and patient-reported data and surveys. Individuals can respond using three discrete values: 0 = No, 1= Yes, somewhat, 2 = Yes, definitely. The measure is calculated using the data element response, passing the measure if an individual responds "Yes, definitely" to receiving the help they wanted for their pain from their palliative care provider and team and failing otherwise (i.e., if an individual responds "Yes, somewhat" or "No"). Surveys must be completed by patients within 6 months of the visit to avoid challenges with recall or loss-to-follow-up which would make findings less actionable. An example data collection and reporting schedule that reflects the process used during testing: identification of all eligible visits during a 3-month or quarterly time-frame, and a subsequent 3- month survey administration/data collection time-frame, with data from all participating programs aggregated over a 12-month, or calendar year reporting period

The Level Of Analysis is performed at Group/Practice level. The score is reported as a rate/proportion. A higher score resulting from this measure should be interpreted, relative to a lower score, as representing better quality of care. Scores are reported at the program level aggregating results over a 12-month, or calendar year reporting period.

www.nationalcoalitionhpc.org/wp-content/uploads/2021/11/MIF-Receiving-Desired-Help-for-Pain.pdf

Brief version: www.nationalcoalitionhpc.org/qualitymeasures/ Full specifications: aahpm.org/uploads/AAHPM22PRO-PMIMPLEMENTATION_GUIDE.pdf, www.nationalcoalitionhpc.org/wp-content/uploads/2021/11/MIF-Receiving-Desired-Help-for-Pain.pdf

Related to NQF item #3666