CMS Hospital IQR Program Measure Comparison Tables FY 2018 (CY 2016) Measures Required to Meet Hospital IQR APU Requirements NHSN Submission
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1 CMS IQR Program Measure Comparison Tables (CY 2016) NHSN Submission CLABSI Central Line-Associated Bloodstream Infection (CLABSI) Required NHSN CAUTI Catheter-Associated Urinary Tract Infection (CAUTI) Required NHSN SSI Surgical Site Infections- Colon Surgery (SSI- Colon and SSI- Required NHSN Abdominal Hysterectomy) MRSA MRSA Bacteremia Required NHSN CDI Clostridium difficile Infection Required NHSN HCP Influenza Vaccination Coverage Among care Personnel Required NHSN Chart-Abstracted ED-1* Median Time from ED Arrival to ED Departure for Admitted ED Patients Required Medical ED-2* Admit Decision Time to ED Departure Time for Admitted Patients Required Medical IMM-2 Influenza Immunization Required Medical PC-01* Elective Delivery Prior to 39 Completed Weeks Gestation Required Medical Sepsis Severe Sepsis and Septic Shock: Management Bundle Required Medical
2 CMS IQR Program Measure Comparison (CY 2016) Chart-Abstracted STK-4* Thrombolytic Therapy Required Medical VTE-5* Venous Thromboembolism Discharge Instructions Required Medical VTE-6* Incidence of Potentially Preventable Venous Thromboembolism Required Medical Claims-Based Measures MORT-30-AMI Acute Myocardial Infarction (AMI) 30-Day Mortality Rate Required Claims MORT-30-HF Heart Failure (HF) 30-Day Mortality Rate Required Claims MORT-30-PN Pneumonia (PN) 30-Day Mortality Rate Required Claims MORT-30- Chronic Obstructive Pulmonary Disease (COPD) 30-Day Mortality Required Claims COPD Rate MORT-30-STK Stroke (STK) 30-Day Mortality Rate Required Claims MORT-30- Coronary Artery Bypass Graft (CABG) 30-day Mortality Rate Required Claims CABG READM-30- AMI Acute Myocardial Infarction (AMI) 30-Day Readmission Rate Required Claims READM-30-HF Heart Failure (HF) 30-Day Readmission Rate Required Claims READM-30-PN Pneumonia (PN) 30-Day Readmission Rate Required Claims READM-30- Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty Required Claims THA/TKA (TKA) 30-Day Readmission Rate READM-30- -Wide All-Cause Unplanned Readmission (HWR) Required Claims HWR READM-30- Chronic Obstructive Pulmonary Disease (COPD) 30-Day Required Claims vember 2015 Page 2 of 7
3 CMS IQR Program Measure Comparison (CY 2016) Claims-Based Measures COPD Readmission Rate READM-30- Stroke (STK) 30-Day Readmission Rate Required Claims STK READM-30- Coronary Artery Bypass Graft (CABG) 30-Day Readmission Rate Required Claims CABG MSPB Medicare Spending per Beneficiary Required Claims AMI Payment AMI Payment per Episode of Care Required Claims HF Payment HF Payment per Episode of Care Required Claims PN Payment PN Payment per Episode of Care Required Claims Hip/Knee Complications PSI-4 Total Hip Arthroplasty (THA)/Total Knee Arthroplasty (TKA) Complication Rate Death Among Surgical Patients with Serious Treatable Complications (Harmonized with Nursing Sensitive Care Measure, Failure to Rescue) Required Claims Required Claims PSI-90 Complication/Patient Safety for Selected Indicators (PSI) Required Claims (composite) THA/TKA THA/TKA Payment per Episode of Care Required Claims Payment AMI Excess Days Excess Days in Acute Care after ization for Acute Myocardial Infarction Required Claims HF Excess Days Excess Days in Acute Care after ization for Heart Failure Required Claims HCAHPS Patient Survey Consumer Assessment of care Providers and Systems Survey (HCAHPS) + 3-Item Care Transition Measure (CTM-3) Required Survey vember 2015 Page 3 of 7
4 CMS IQR Program Measure Comparison (CY 2016) Patient Safety Culture Registry for Nursing Sensitive Care Registry for General Surgery Safe Surgery Checklist Structural Measures Survey on Patient Safety Culture Required Web-based Participation in a Systematic Clinical base Registry for Required Web-based Nursing Sensitive Care Participation in a Systematic Clinical base Registry for General Surgery Required Web-based Safe Surgery Checklist Use Required Web-based ally Specified Clinical Quality Measures (ecqms) AMI-2 Aspirin Prescribed at Discharge for AMI AMI-7a Fibrinolytic Therapy Received Within 30 Minutes of Arrival AMI-8a Primary PCI Received Within 90 Minutes of Arrival AMI-10 Statin Prescribed at Discharge CAC-3 Home Management Plan of Care (HMPC) Document Given to Patient/Caregiver vember 2015 Page 4 of 7
5 CMS IQR Program Measure Comparison (CY 2016) ally Specified Clinical Quality Measures (ecqms) ED-1* Median Time from ED Arrival to ED Departure for Admitted ED Patients ED-2* Admit Decision Time to ED Departure Time for Admitted Patients EHDI-1a Hearing Screening Prior to Discharge HTN y Term Newborn PC-01* Elective Delivery Prior to 39 Completed Weeks Gestation. PC-05 Exclusive Breast Milk Feeding and the subset measure: PC-05a Exclusive Breast Milk Feedings considering Mother s Choice PN-6 Initial Antibiotic Selection for CAP in Immunocompetent Patient SCIP-Inf-1 Prophylactic Antibiotic Received Within One Hour Prior to Surgical Incision SCIP-Inf-2 Prophylactic Antibiotic Selection for Surgical Patients SCIP-Inf-9 Urinary Catheter Removed on Postoperative Day 1 (POD 1) or Postoperative Day 2 (POD 2) with Day of Surgery being Day Zero vember 2015 Page 5 of 7
6 CMS IQR Program Measure Comparison (CY 2016) ally Specified Clinical Quality Measures (ecqms) STK-2 Discharged on Antithrombotic Therapy STK-3 Anticoagulation Therapy for Atrial Fibrillation/Flutter STK-4* Thrombolytic Therapy STK-5 Antithrombotic Therapy By End of Day 2 STK-6 Discharged on Statin Medication STK-8 Stroke Education STK-10 Assessed for Rehabilitation VTE-1 Venous Thromboembolism Prophylaxis VTE-2 Intensive Care Unit Venous Thromboembolism Prophylaxis VTE-3 Venous Thromboembolism Patients with Anticoagulation Overlap Therapy vember 2015 Page 6 of 7
7 CMS IQR Program Measure Comparison (CY 2016) ally Specified Clinical Quality Measures (ecqms) VTE-4 Venous Thromboembolism Patients Receiving Unfractionated Heparin with Dosages/Platelet Count Monitoring by Protocol or mogram VTE-5* Venous Thromboembolism Discharge Instructions VTE-6* Incidence of Potentially Preventable Venous Thromboembolism Removal of Chart-Abstracted Measures (*Retained as ecqm for the IQR Program) Criteria STK-1 Venous Thromboembolism (VTE) Prophylaxis Topped Out STK-6* Discharged on Statin Medication Topped Out STK-8* Stroke Education Topped Out VTE-1* Venous Thromboembolism Prophylaxis Topped Out VTE-2* Intensive Care Unit Venous Thromboembolism Prophylaxis Topped Out VTE-3* Venous Thromboembolism Patients with Anticoagulation Overlap Therapy Topped Out IMM-1 Pneumococcal Immunization Infeasibility to Implement SCIP-Inf-4 Cardiac Surgery Patients with Controlled Postoperative Blood Glucose Does not result in better patient outcomes AMI-7a* Fibrinolytic Therapy Received Within 30 Minutes of Arrival Leads to negative unintended consequences vember 2015 Page 7 of 7
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