Clinician-Group Risk-Standardised Acute Hospital Admission Rate for Patients With Multiple Chronic Conditions Under the Merit-Based Incentive Payment System
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
Numerator
The outcome for this measure is the number of acute admissions per 100 person-years at risk for admission during the measurement period.
Denominator
Patients included in the measure (target patient population)
The target patient population for the outcome includes Medicare FFS patients aged 65 years and older with multiple chronic conditions (MCCs).
Provider types included for measurement
• Primary care providers (PCPs): CMS designates PCPs as physicians who practice internal medicine, family medicine, general medicine, or geriatric medicine, and non-physician providers, including nurse practitioners, certified clinical nurse specialists, and physician assistants.
• Relevant specialists: Specialists covered by the measure are limited to those who provide overall co-ordination of care for patients with MCCs and who manage the chronic diseases that put the MCCs patients in the measure at risk of admission. These specialists were chosen with input from our Technical Expert Panel (TEP) and include cardiologists, pulmonologists, nephrologists, neurologists, endocrinologists, and hematologists/oncologists. However, as indicated below and in Section S.9, the measure is not designed to assess the quality of care of cancer specialists who are actively managing cancer patients, and thus patients attributed to hematologists and oncologists are excluded from the measure.
Exclusions
We exclude patients from the cohort for these reasons:
Patients without continuous enrolment in Medicare Part A or B during the measurement period.
Patients enrolled in hospice at any time during the year prior to the measurement year or at start of the measurement year.
Patients with no E&M visit to a MIPS eligible clinician.
Patients assigned to clinicians who do not participate in the QPP on the MIPS track.
Patients attributed to hematologists and oncologists.
Patients not at risk for hospitalisation during the measurement year.
Use of Risk Adjustment
Risk Adjustments
Statistical risk model
Stratifications
Clinician: Group/Practice
Data Attributes
Type of Data Collection
Data Collection Methods
Claims data
Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
Source and Reference Attributes
Evidence Source
National Quality Forum 2022 Key Rural Measures: An Update List of Measures to Advance Rural Health Priorities, Draft 1, page 1-26
Technical Specifications
Download from: www.qualityforum.org/Publications/2022/08/2022KeyRural_Measures__An_Updated_List_of_Measures_to_Advance_Rural_Health_Priorities.aspx
Technical Specifications: p4qm.org/measures/3597