Number of patients in an outpatient clinical practice who have had a qualifying event/diagnosis during the previous 12 months, who have been referred to an outpatient Cardiac Rehabilitation/Secondary Prevention (CR/SP) program. (Note: The program may include a traditional CR/SP program based on face-to-face interactions and training sessions or may include other options such as home-based approaches. If alternative CR/SP approaches are used, they should be designed to meet appropriate safety standards and deliver effective, evidence-based services.)

Number of patients in an outpatient clinical practice who have had a qualifying cardiovascular event in the previous 12 months and who do not meet any of the criteria listed in the denominator exclusion section below, and who have not participated in an outpatient cardiac rehabilitation program since the qualifying event/diagnosis.

Exceptions criteria require documentation of one or more of the following factors that may prohibit cardiac rehabilitation participation: Medical factors (e.g., patient deemed by provider to have a medically unstable, life-threatening condition). Health care system factors (e.g., no cardiac rehabilitation/secondary prevention (CR/SP) program available within 60 min of travel time from the patient's home).

The only exclusion criterion for this measure is noted below: Patients already referred to CR from another provider/facility and/or was participating in CR prior to encounter with provider at the current office/facility.(1) When the provider discusses CR/SP referral with the patient, if the patient indicates that he/she has already been referred to CR/SP, then that provider would not be expected to make another referral. However, the provider should document that information in the medical record.

None

None

Electronic Health Records: Electronic Health Records, Registry Data

Quarterly

American Medical Association (AMA). Cardiac Rehabilitation Patient Referral from an Outpatient Setting.2019 Accessed August 17, 2023. Available from: cvquality.acc.org/docs/default-source/pinnacle/2020/2020measure243_mipscqm.pdf. Cardiac Rehabilitation Patient Referral From an Outpatient Setting [Internet]. National Quality Forum. [cited August 18, 2023]. Available from: www.qualityforum.org/QPS/0643.

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