CMS Hospital Inpatient Quality Reporting (IQR) Program Measures for the FY 2019 Payment Update
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1 CMS Inpatient Quality Reporting (IQR) Program Measures for the Update Measures Required to Meet IQR Program APU Requirements NHSN Submission CAUTI National Healthcare Safety Network (NHSN) Catheter-Associated Urinary Tract NHSN Yes Yes Infection (CAUTI) Outcome Measure CDI National Healthcare Safety Network (NHSN) Facility-Wide Inpatient -Onset NHSN Yes Yes Clostridium difficile Infection (CDI) Outcome Measure CLABSI National Healthcare Safety Network (NHSN) Central Line-Associated Bloodstream NHSN Yes Yes Infection (CLABSI) Outcome Measure Colon and American College of Surgeons Centers for Disease Control and Prevention (ACS- NHSN Yes Yes Abdominal Hysterectomy SSI CDC) Harmonized Procedure Specific Surgical Site Infection (SSI) Outcome Measure HCP Influenza Vaccination Coverage Among Healthcare Personnel NHSN Yes No MRSA Bacteremia National Healthcare Safety Network (NHSN) Facility-Wide Inpatient -Onset Methicillin-resistant Staphylococcus aureus (MRSA) Bacteremia Outcome Measure NHSN Yes Yes Chart-Abstracted ED-1 * Median Time from ED Arrival to ED Departure for Admitted ED Patients Medical Record Yes No ED-2 * Admit Decision Time to ED Departure Time for Admitted Patients Medical Record Yes No IMM-2 Influenza Immunization Medical Record Yes No PC-01 * Elective Delivery Medical Record Yes Yes Sepsis Severe Sepsis and Septic Shock: Management Bundle (Composite Measure) Medical Record Yes No VTE-6 Incidence of Potentially Preventable Venous Thromboembolism Medical Record Yes No * Measure is listed twice, as both chart-abstracted and ecqm.
2 CMS IQR Program Measures Claims-Based Outcome on MORT-30-AMI 30-Day, All-Cause, Risk-Standardized Mortality Rate (RSMR) Following Claims Yes Yes Acute Myocardial Infarction (AMI) ization MORT-30-CABG 30-Day, All-Cause, Risk-Standardized Mortality Rate (RSMR) Following Coronary Artery Bypass Graft (CABG) Surgery MORT-30-COPD 30-Day, All-Cause, Risk-Standardized Mortality Rate (RSMR) Following Chronic Obstructive Pulmonary Disease (COPD) ization MORT-30-HF 30-Day, All-Cause, Risk-Standardized Mortality Rate (RSMR) Following Claims Yes Yes Heart Failure (HF) ization MORT-30-PN 30-Day, All-Cause, Risk-Standardized Mortality Rate Following Claims Yes Yes Pneumonia ization MORT-30-STK 30-Day, All-Cause, Risk-Standardized Mortality Rate Following Acute Ischemic READM-30-AMI 30-Day All-Cause Risk-Standardized Readmission Rate (RSRR) Following Acute Myocardial Infarction (AMI) ization READM-30-CABG 30-Day, All-Cause, Unplanned, Risk-Standardized Readmission Rate (RSRR) Following Coronary Artery Bypass Graft (CABG) Surgery READM-30-COPD 30-Day, All-Cause, Risk-Standardized Readmission Rate (RSRR) Following Chronic Obstructive Pulmonary Disease (COPD) ization READM-30-HF 30-Day, All-Cause, Risk-Standardized Readmission Rate (RSRR) Following Heart Failure (HF) ization READM-30-HWR -Wide All-Cause Unplanned Readmission (HWR) READM-30-PN 30-Day, All-Cause, Risk-Standardized Readmission Rate (RSRR) Following Pneumonia ization READM-30-STK 30-Day Risk Standardized Readmission Rate Following Stroke ization READM-30- THA/TKA -Level 30-Day, All-Cause Risk-Standardized Readmission Rate (RSRR) Following Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA) AMI Excess Days Excess Days in Acute Care after ization for Acute Myocardial Infarction HF Excess Days Excess Days in Acute Care after ization for Heart Failure PN Excess Days Excess Days in Acute Care after ization for Pneumonia Hip/Knee Complications -Level Risk-Standardized Complication Rate (RSCR) Following Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA) Claims Yes Yes July 2017 Page 2 of 5
3 CMS IQR Program Measures Claims-Based Outcome on PSI 04 Death Rate Among Surgical Patients with Serious Treatable Complications PSI 90 Patient Safety and Adverse Events Composite Claims Yes Yes Claims-Based on AMI -Level, Risk-Standardized Associated with a 30-Day Episode-of- Care for Acute Myocardial Infarction (AMI) HF -Level, Risk-Standardized Associated with a 30-Day Episode-of- Care for Heart Failure (HF) PN -Level, Risk-Standardized Associated with a 30-Day Episode-of- Care for Pneumonia THA/TKA -Level, Risk-Standardized Associated with an Episode-of-Care for Primary Elective Total Hip Arthroplasty and/or Total Knee Arthroplasty MSPB -Standardized Medicare Spending Per Beneficiary (MSPB) Claims Yes Yes Cellulitis Cellulitis Clinical Episode-Based GI Gastrointestinal Hemorrhage Clinical Episode-Based Kidney/UTI Kidney/Urinary Tract Infection Clinical Episode-Based AA Aortic Aneurysm Procedure Clinical Episode-Based Chole and CDE Cholecystectomy and Common Duct Exploration Clinical Episode-Based SFusion Spinal Fusion Clinical Episode-Based July 2017 Page 3 of 5
4 CMS IQR Program Measures ecqms AMI-8a Primary PCI Received Within 90 Minutes of Arrival EHR No No CAC-3 Home Management Plan of Care Document Given to Patient/Caregiver EHR No No ED-1* Median Time from ED Arrival to ED Departure for Admitted ED Patients EHR No No ED-2* Admit Decision Time to ED Departure Time for Admitted Patients EHR No No EHDI-1a Hearing Screening Prior to Discharge EHR No No PC-01* Elective Delivery EHR No No PC-05 Exclusive Breast Milk Feeding EHR No No STK-2 Discharged on Antithrombotic Therapy EHR No No STK-3 Anticoagulation Therapy for Atrial Fibrillation/Flutter EHR No No STK-5 Antithrombotic Therapy by the End of Day Two EHR No No STK-6 Discharged on Statin Medication EHR No No STK-8 Stroke Education EHR No No STK-10 Assessed for Rehabilitation EHR No No VTE-1 Venous Thromboembolism Prophylaxis EHR No No VTE-2 Intensive Care Unit Venous Thromboembolism Prophylaxis EHR No No * Measure is listed twice, as both chart-abstracted and ecqm. Patient Experience of Care Survey HCAHPS HCAHPS + 3-Item Care Transition Measure (CTM-3) Patient Survey Yes Yes Structural Patient Safety Culture Survey on Patient Safety Culture Web-Based Tool Yes No Safe Surgery Checklist Safe Surgery Checklist Use Web-Based Tool Yes No July 2017 Page 4 of 5
5 CMS IQR Program Measures Acronyms AA Aortic Aneurysm HF Heart Failure AMI Acute Myocardial Infarction HMPC Home Management Plan of Care APU Annual Update HVBP Value-Based Purchasing CABG Coronary Artery Bypass Graft IQR Inpatient Quality Reporting CAUTI Catheter-Associated Urinary Tract Infection MRSA Methicillin-resistant Staphylococcus aureus CDE Common Duct Exploration MSPB Medicare Spending per Beneficiary CDI Clostridium difficile Infection NHSN National Healthcare Safety Network CLABSI Central Line-Associated Bloodstream Infection PCI Percutaneous Coronary Intervention CMS Centers for Medicare & Medicaid Services PN Pneumonia COPD Chronic Obstructive Pulmonary Disease PSI Patient Safety Indicator CY Calendar Year SSI Surgical Site Infection ecqm Electronic Clinical Quality Measure STK Stroke ED Emergency Department THA Total Hip Arthroplasty EHR Electronic Health Record TKA Total Knee Arthroplasty FY Fiscal Year UTI Urinary Tract Infection HCAHPS Consumer Assessment of Healthcare Providers and Systems VTE Venous Thromboembolism HCP Healthcare Personnel July 2017 Page 5 of 5
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