Ratio of Observed Over Predicted Rates for Diagnosis of Cognitive Impairment of Any Stage

Identifying Attributes

Care Settings
Primary Care
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS)
Type of Quality Indicator
Process
IOM Quality Dimension
Effectiveness
Domain
Dementia and Cognition

Defining Attributes

Definition

The ratio of the number of patients, who are attributed to a clinician or practice, with a diagnosis of any stage of cognitive impairment over the expected number of cases based on a predictive model. Once the clinician's or practice's O/E ratio (i.e., ratio of the observed and expected rates) is calculated, a computation of its associated standard error (SE) can be used to draw inference whether the O/E ratio is significantly different from 1 or not.

Numerator

Number of Medicare beneficiaries aged 65 and older, who are attributed to a clinician or practice and who have been diagnosed with any stage cognitive impairment based on claims data.

Denominator

Number of expected cases with dementia among the panel of Medicare beneficiaries aged 65 and older attributed to a clinician or practice based on a predictive model.

Exclusions
Use of Risk Adjustment
No
Risk Adjustments

None

Stratifications

Collection and Reporting Attributes

Type of Data Collection
Administrative data
Data Collection Methods

Reporting is specific to sub-program

Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
No

Source and Reference Attributes

Evidence Source
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
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
No
Australian Consortium for Aged Care Endorsed
No
Identified by PHARMA-Care Project
No
Upload Date
02 December 2025