Cardiac Rehabilitation Patient Referral From an Inpatient Setting

Identifying Attributes

Care Settings
Rehabilitation Care
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Hospital Outpatient Quality Reporting Program
Type of Quality Indicator
Process
IOM Quality Dimension
Effectiveness
Domain
Access

Defining Attributes

Definition

Percentage of patients who patients who have had one of the following qualifying events/diagnosis during their current inpatient encounter that are referred to an outpatient cardiac rehabilitation program. Qualifying events: • Diagnosis of a myocardial infarction (MI) • Coronary artery bypass graft (CABG) surgery • Percutaneous coronary intervention (PCI) • Cardiac valve repair/replacement.

Numerator

Number of eligible patients with a qualifying event/diagnosis who have been referred to an outpatient Cardiac Rehabilitation/Secondary Prevention (CR/SP) program prior to hospital discharge or have a documented medical or patient centred reason why such a referral was not made.

Denominator

Number of patients who are discharged from the hospital with a qualifying event/diagnosis (i.e. MI, PCI, CABG, valve repair/replacement).

Exclusions

Patients less than 18 years of age Patients with a documented Reason for No Referral to Outpatient Cardiac Rehabilitation Program Patients who expired Patients who left against medical advice (AMA) Patients discharged to another hospital Patients discharged to another healthcare facility Patients discharged to home for hospice care Patients discharged to a healthcare facility for hospice care Patients who have a Length of Stay greater than 120 days Patients enrolled in a Clinical Trial Patients with Comfort Measures Only documented Patients who had a left ventricular assist device (LVAD) or heart transplant procedure (ICD-10-PCS Procedure Code for LVAD or heart transplant as defined in Appendix A, Table 2.2 or Table 2.13).

Use of Risk Adjustment
No
Risk Adjustments

None

Stratifications

None

Data Attributes

Type of Data Collection
Data Collection Methods

Not Applicable.

Frequency of Data Collection
Not Applicable
Frequency of Data Collection in Days
Reporting Methods

Hospital Outpatient Quality Program (Inactive) Million Hearts (Active).

Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
No

Source and Reference Attributes

Evidence Source

Centers for Medicare & Medicaid Services (CMS), United States. Cardiac Rehabilitation Patient Referral From an Inpatient Setting (Hospital Outpatient Quality Reporting Program). Accessed August 3, 2023. Available from: cmit.cms.gov/cmit/#/MeasureView?variantId=3800&sectionNumber=7.

Centers for Medicare & Medicaid Services (CMS), United States. Cardiac Rehabilitation Patient Referral From an Inpatient Setting (Million Harts). Accessed August 3, 2023. Available from: cmit.cms.gov/cmit/#/MeasureView?variantId=3801&sectionNumber=7.

Centers for Medicare & Medicaid Services (CMS), United States. Cardiac Rehabilitation Patient Referral From an Inpatient Setting (Bundled Payment for Care Improvement Advanced Model). Accessed August 3, 2023. Available from: cmit.cms.gov/cmit/#/MeasureView?variantId=12570&sectionNumber=1.

Technical Specifications

Data reporting (Hospital Outpatient Quality Program): cmit.cms.gov/cmit/#/MeasureView?variantId=3800&sectionNumber=7

Data reporting (Million Hearts): cmit.cms.gov/cmit/#/MeasureView?variantId=3801&sectionNumber=7

Data reporting (Bundled Payment for Care Improvement Advanced Model): cmit.cms.gov/cmit/#/MeasureView?variantId=12570&sectionNumber=7

Technical specifications: cmit.cms.gov/cmit/#/MeasureView?variantId=12570&sectionNumber=1

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
12 March 2025