2017 CMS Web Interface

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1 CMS Web Interface CARE-2 (NQF 0101): Falls: Screening fr Future Fall Risk Measure Steward: NCQA Web Interface V1.0 Page 1 f 18 11/15/2016

2 Cntents INTRODUCTION... 3 WEB INTERFACE SAMPLING INFORMATION... 4 BENEFICIARY SAMPLING... 4 NARRATIVE MEASURE SPECIFICATION... 5 DESCRIPTION:... 5 IMPROVEMENT NOTATION:... 5 INITIAL POPULATION:... 5 DENOMINATOR:... 5 DENOMINATOR EXCLUSIONS:... 5 DENOMINATOR EXCEPTIONS:... 5 NUMERATOR:... 5 NUMERATOR EXCLUSIONS:... 5 DEFINITIONS:... 5 GUIDANCE:... 5 SUBMISSION GUIDANCE... 6 PATIENT CONFIRMATION... 6 SUBMISSION GUIDANCE... 7 DENOMINATOR CONFIRMATION... 7 SUBMISSION GUIDANCE... 8 NUMERATOR REPORTING... 8 DOCUMENTATION REQUIREMENTS... 9 APPENDIX I: PERFORMANCE CALCULATION FLOW APPENDIX II: DOWNLOADABLE RESOURCE MAPPING TABLE APPENDIX III: MEASURE RATIONALE AND CLINICAL RECOMMENDATION STATEMENTS RATIONALE: CLINICAL RECOMMENDATION STATEMENTS: APPENDIX IV: USE NOTICES, COPYRIGHTS, AND DISCLAIMERS COPYRIGHT Web Interface V1.0 Page 2 f 18 11/15/2016

3 INTRODUCTION There are a ttal f 15 individual measures (including ne cmpsite cnsisting f tw measures) included in the CMS Web Interface targeting high-cst chrnic cnditins, preventive care, and patient safety. The measures dcuments are represented individually and cntain measure specific infrmatin. The crrespnding cding dcuments are psted separately in an Excel frmat. The Measure Dcuments are being prvided t allw grup practices and Accuntable Care Organizatins (ACOs) an pprtunity t better understand each f the 15 individual measures included in the CMS Web Interface data submissin methd. Each Measure Dcument cntains infrmatin necessary t submit data thrugh the CMS Web Interface. Narrative specificatins, supprting submissin dcumentatin, and calculatin flws are prvided within each dcument. Please review all f the measure dcumentatin in its entirety t ensure cmplete understanding f these measures. Web Interface V1.0 Page 3 f 18 11/15/2016

4 WEB INTERFACE SAMPLING INFORMATION BENEFICIARY SAMPLING Fr mre infrmatin n the sampling prcess and methdlgy please refer t the Web Interface Sampling Dcument, available at CMS.gv. Web Interface V1.0 Page 4 f 18 11/15/2016

5 NARRATIVE MEASURE SPECIFICATION DESCRIPTION: Percentage f patients 65 years f age and lder wh were screened fr future fall risk during the measurement perid IMPROVEMENT NOTATION: Higher scre indicates better quality INITIAL POPULATION: Patients aged 65 years and lder with a visit during the measurement perid DENOMINATOR: Equals Initial Ppulatin DENOMINATOR EXCLUSIONS: Nne DENOMINATOR EXCEPTIONS: Dcumentatin f medical reasn(s) fr nt screening fr fall risk (eg, patient is nt ambulatry) NUMERATOR: Patients wh were screened fr future fall risk at least nce within the measurement perid NUMERATOR EXCLUSIONS: Nt Applicable DEFINITIONS: Screening fr Future Fall Risk: Assessment f whether an individual has experienced a fall r prblems with gait r balance. A specific screening tl is nt required fr this measure, hwever ptential screening tls include the Mrse Fall Scale and the timed Get-Up-And-G test. Fall: A sudden, unintentinal change in psitin causing an individual t land at a lwer level, n an bject, the flr, r the grund, ther than as a cnsequence f sudden nset f paralysis, epileptic seizure, r verwhelming external frce. GUIDANCE: Nne Web Interface V1.0 Page 5 f 18 11/15/2016

6 PATIENT CONFIRMATION SUBMISSION GUIDANCE Establishing patient eligibility fr reprting requires the fllwing: Guidance Determine if the patient s medical recrd can be fund If yu can lcate the medical recrd select Yes OR OR If yu cannt lcate the medical recrd select N - Medical Recrd Nt Fund Determine if the patient is qualified fr the sample If the patient is deceased, in hspice, mved ut f the cuntry r was enrlled in HMO select Nt Qualified fr Sample, select the applicable reasn frm the prvided drp-dwn menu, and enter the date the patient became ineligible Patient Cnfirmatin If N Medical Recrd Nt Fund r Nt Qualified fr Sample is selected, the patient is cmpleted but nt cnfirmed. The patient will be skipped and anther patient must be reprted in their place, if available. The Web Interface will autmatically skip any patient fr whm N Medical Recrd Nt Fund r Nt Qualified fr Sample is selected in all ther measures int which they have sampled. If Nt Qualified fr Sample is selected and the date is unknwn, yu may enter the last date f the measurement perid (i.e., 12/31/). The Measurement Perid is defined as January 1 December 31,. NOTE: - In Hspice: Select this ptin if the patient is nt qualified fr sample due t being in hspice care at any time during the measurement perid (this includes nn-hspice patients receiving palliative gals r cmfrt care) - Mved ut f Cuntry: Select this ptin if the patient is nt qualified fr sample because they mved ut f the cuntry any time during the measurement perid - Deceased: Select this ptin if the patient died during the measurement perid - HMO Enrllment: Select this ptin if the patient was enrlled in an HMO at any time during the measurement perid (i.e., Medicare Advantage, nn-medicare HMOs, etc.)

7 DENOMINATOR CONFIRMATION Guidance SUBMISSION GUIDANCE Determine if the patient is qualified fr the measure. OR If yu are able t cnfirm the patient is qualified fr the measure select Yes If there is an ther CMS apprved reasn fr patient disqualificatin frm the measure select N - Other CMS Apprved Reasn Denminatr CMS Apprved Reasn may nly be selected when apprved by CMS. T request a CMS Apprved Reasn, yu wuld need t prvide the patient rank, measure, and reasn fr request in a Quality Payment Prgram Service Desk inquiry. A CMS decisin will be prvided in the reslutin f the inquiry. Patients fr whm a CMS Apprved Reasn is selected will be skipped and anther patient must be reprted in their place, if available. By selecting "N - Other CMS Apprved Reasn", the patient is nly remved frm the measure fr which the reasn was requested, nt all Web Interface measures. Web Interface V1.0 Page 7 f 18 11/15/2016

8 NUMERATOR REPORTING SUBMISSION GUIDANCE Determine if patient was screened fr future fall risk at least nce during the measurement perid OR OR If patient was nt screened fr future fall risk select N If the patient was nt screened fr future fall risk fr a medical reasn select N - Denminatr Exceptin Medical Reasns If patient was screened fr future fall risk select Yes Numeratr and Denminatr Exceptin cdes can be fund in the Web Interface CARE Cding Dcument. The Dwnladable Resurce Mapping Table can be lcated in Appendix II f this dcument. Guidance NOTE: Numeratr - A clinician with apprpriate skills and experience may perfrm the screening - Setting f screening is nt restricted t an ffice setting - Dcumentatin f n falls is sufficient - Medical recrd must include dcumentatin f screening perfrmed - Any histry f falls screening during the measurement perid is acceptable as meeting the intent f the measure - A gait r balance assessment meets the intent f the measure - Screening fr future fall risk may be cmpleted during a telehealth encunter - Denminatr Exceptin, cunt as nn-ambulatry nly if nn-ambulatry at the mst recent encunter during the measurement perid Web Interface V1.0 Page 8 f 18 11/15/2016

9 DOCUMENTATION REQUIREMENTS When submitting data thrugh the CMS Web Interface, the expectatin is that medical recrd dcumentatin is available that supprts the actin reprted in the Web Interface i.e., medical recrd dcumentatin is necessary t supprt the infrmatin that has been submitted. Web Interface V1.0 Page 9 f 18 11/15/2016

10 Appendix I: Perfrmance Calculatin Flw Web Interface V1.0 Page 10 f 18 11/15/2016

11 Web Interface V1.0 Page 11 f 18 11/15/2016

12 Web Interface V1.0 Page 12 f 18 11/15/2016

13 Patient Cnfirmatin Flw Fr, cnfirmatin f the Medical Recrd Fund, r indicating the patient is Nt Qualified fr Sample with a reasn f In Hspice, Mved ut f Cuntry, Deceased, r HMO Enrllment, will nly need t be dne nce per patient. Refer t the Measure Reprting Dcument fr further instructins. 1. Start Patient Cnfirmatin Flw. 2. Check t determine if Medical Recrd can be fund. a. If n, Medical Recrd nt fund, mark apprpriately fr cmpletin and stp abstractin. This remves the patient frm the beneficiary sample fr all measures. The patient will be skipped and replaced. Stp prcessing. b. If yes, Medical Recrd fund, cntinue prcessing. 3. Check t determine if Patient Qualified fr the sample. a. If n, the patient des nt qualify fr the sample, select the reasn why and enter the date (if date is unknwn, enter 12/31/) the patient became ineligible fr sample. Fr example; In Hspice, Mved ut f Cuntry, Deceased, HMO Enrllment. Mark apprpriately fr cmpletin and stp abstractin. This remves the patient frm the beneficiary sample fr all measures. The patient will be skipped and replaced. Stp prcessing. b. If yes, the patient des qualify fr the sample; cntinue t the Measure Cnfirmatin Flw fr CARE-2. Web Interface V1.0 Page 13 f 18 11/15/2016

14 Measure Cnfirmatin Flw fr CARE-2 Fr, measure specific reasns a patient is Nt Cnfirmed r excluded fr Denminatr Exclusin r Other CMS Apprved Reasn will need t be dne fr each measure where the patient appears. Refer t the Measure Reprting Dcument fr further instructins. 1. Start Measure Cnfirmatin Flw fr CARE-2. Cmplete fr cnsecutively ranked patients aged 65 years and lder at the beginning f the measurement perid. Further infrmatin regarding patient selectin fr specific disease and patient care measures can be fund in the Web Interface Sampling Methdlgy Dcument. Fr patients wh have the incrrect date f birth listed, a change f the patient date f birth by the abstractr may result in the patient n lnger qualifying fr the CARE-2 measure. If this is the case, the system will autmatically remve the patient frm the measure requirements. 2. Check t determine if the patient qualifies fr the measure (Other CMS Apprved Reasn). a. If n, the patient des nt qualify fr the measure select: N Other CMS Apprved Reasn fr patient disqualificatin. Mark apprpriately fr cmpletin and stp abstractin. Patient is remved frm the perfrmance calculatins fr this measure. The patient will be skipped and replaced. Other CMS Apprved Reasn may nly be selected by if yu have received an apprval frm CMS in the reslutin f a requested Quality Payment Prgram Service Desk Inquiry at QPP Service Desk . Stp prcessing. b. If yes, the patient des qualify fr the measure, cntinue t the CARE-2 measure flw. Web Interface V1.0 Page 14 f 18 11/15/2016

15 Measure Flw fr CARE-2 The measure diagrams were develped by CMS as a supplemental resurce t be used in cnjunctin with the measure specificatins. They shuld nt be used as a substitutin fr the measure specificatins. Fr Dwnladable Resurce Mapping Table, g t Appendix II and use the Variable Names lcated in the appendix alng with the applicable tabs within the CARE Cding Dcument. 1. Start prcessing CARE-2 (NQF 0101) Flw fr the patients that qualified fr sample in the Patient Cnfirmatin Flw and the Measure Cnfirmatin Flw fr Care-2. Nte: Include remainder f patients listed in the Web Interface that were cnsecutively cnfirmed and cmpleted fr this measure in the denminatr. Fr the sample calculatin in the flw these patients wuld fall int the d categry (eligible denminatr, i.e. 248 patients). 2. Check t determine if the patient was screened fr future fall risk at least nce during the measurement perid. a. If n, the patient was nt screened fr future fall risk at least nce during the measurement perid, cntinue prcessing. b. If yes, the patient was screened fr future fall risk at least nce during the measurement perid, perfrmance is met and the patient will be included in the numeratr. Fr the sample calculatin in the flw these patients wuld fall int the a categry (numeratr, i.e. 212 patients). Stp prcessing. 3. Check t determine if the patient was nt screened fr future fall risk at least nce during the measurement perid fr a denminatr exceptin, medical reasn (s). a. If n, the patient was nt screened fr future fall risk at least nce during the measurement perid fr a denminatr exceptin, medical reasn(s), perfrmance is nt met and shuld nt be included in the numeratr. Stp prcessing. b. If yes, the patient was nt screened fr future fall risk at least nce during the measurement perid fr a denminatr exceptin, medical reasn(s), this is a denminatr exceptin and the case shuld be subtracted frm the denminatr. Fr the sample calculatin in the flw these patients wuld fall int the b categry (denminatr exceptin, i.e. 6 patients). Stp prcessing. Sample Calculatin Perfrmance Rate Equals Perfrmance Met is categry a in the measure flw (212 patients) Denminatr Exceptin is categry b in measure flw (6 patients) Denminatr is categry d in measure flw (248 patients) 212 (Perfrmance Met) divided by 242 (Denminatr minus Denminatr Exceptin) equals a perfrmance rate f percent Calculatin May Change Pending Perfrmance Met Web Interface V1.0 Page 15 f 18 11/15/2016

16 Appendix II: Dwnladable Resurce Mapping Table Each data element within this measure s denminatr r numeratr is defined as a pre-determined set f clinical cdes. These cdes can be fund in the Web Interface CARE Cding Dcument. *CARE-2: Falls: Screening fr Future Fall Risk Measure Cmpnent/Excel Tab Data Element Variable Name Cding System(s) Numeratr/Numeratr Cdes Falls Screening FALLS_SCREEN_CODE LN SNM Denminatr Exceptin/ Exceptin NOT_AMBULATORY_CODE SNM Denminatr Exceptin Cdes MEDICAL_REASON SNM *Fr EHR mapping, the cding within CARE-2 is cnsidered t be all inclusive Web Interface V1.0 Page 16 f 18 11/15/2016

17 Appendix III: Measure Ratinale and Clinical Recmmendatin Statements RATIONALE: As the leading cause f bth fatal and nnfatal injuries fr lder adults, falls are ne f the mst cmmn and significant health issues facing peple aged 65 years r lder (Schneider, Shubert and Harmn 2010). Mrever, the rate f falls increases with age (Dykes et al. 2010). Older adults are five times mre likely t be hspitalized fr fall-related injuries than any ther cause-related injury. It is estimated that ne in every three adults ver 65 will fall each year (Centers fr Disease Cntrl and Preventin 2015). In thse ver age 80, the rate f falls increases t fifty percent (Dherty et al. 2009). Falls are als assciated with substantial cst and resurce use, appraching $30,000 per fall hspitalizatin (Wlctt et al. 2011). Identifying at-risk patients is the mst imprtant part f management, as applying preventive measures in this vulnerable ppulatin can have a prfund effect n public health (al-aama 2011). Family physicians have a pivtal rle in screening lder patients fr risk f falls, and applying preventive strategies fr patients at risk (al-aama 2011). CLINICAL RECOMMENDATION STATEMENTS: All ther persns wh are under the care f a health prfessinal (r their caregivers) shuld be asked at least nce a year abut falls. (AGS/BGS/AAOS) Older persns wh present fr medical attentin because f a fall, reprt recurrent falls in the past year, r demnstrate abnrmalities f gait and/r balance shuld have a fall evaluatin perfrmed. This evaluatin shuld be perfrmed by a clinician with apprpriate skills and experience, which may necessitate referral t a specialist (eg, geriatrician). (AGS/DGS/AAOS) Older peple in cntact with health care prfessinals shuld be asked rutinely whether they have fallen in the past year and asked abut the frequency, cntext, and characteristics f the falls. (NICE) (Grade C) Older peple reprting a fall r cnsidered at risk f falling shuld be bserved fr balance and gait deficits and cnsidered fr their ability t benefit frm interventins t imprve strength and balance. (NICE) (Grade C) Web Interface V1.0 Page 17 f 18 11/15/2016

18 Appendix IV: Use Ntices, Cpyrights, and Disclaimers COPYRIGHT Physician Perfrmance Measures (Measures) and related data specificatins, develped by the American Medical Assciatin (AMA)-cnvened Physician Cnsrtium fr Perfrmance Imprvement (PCPI ) and the Natinal Cmmittee fr Quality Assurance (NCQA) pursuant t gvernment spnsrship under subcntract with Mathematica Plicy Research, Inc. under cntract with Centers fr Medicare & Medicaid Services. These perfrmance Measures are nt clinical guidelines and d nt establish a standard f medical care, and have nt been tested fr all ptential applicatins. The Measures, while cpyrighted, can be reprduced and distributed, withut mdificatin, fr nncmmercial purpses, eg, use by health care prviders in cnnectin with their practices. Cmmercial use is defined as the sale, license, r distributin f the Measures fr cmmercial gain, r incrpratin f the Measures int a prduct r service that is sld, licensed r distributed fr cmmercial gain. Cmmercial uses f the Measures require a license agreement between the user and the AMA, (n behalf f the PCPI) r NCQA. Neither the AMA, NCQA, PCPI nr its members shall be respnsible fr any use f the Measures. THE MEASURES AND SPECIFICATIONS ARE PROVIDED AS IS WITHOUT WARRANTY OF ANY KIND American Medical Assciatin and Natinal Cmmittee fr Quality Assurance. All Rights Reserved. Limited prprietary cding is cntained in the Measure specificatins fr cnvenience. Users f the prprietary cde sets shuld btain all necessary licenses frm the wners f these cde sets. The AMA, NCQA, the PCPI and its members disclaim all liability fr use r accuracy f any Current Prcedural Terminlgy (CPT ) r ther cding cntained in the specificatins. Web Interface V1.0 Page 18 f 18 11/15/2016

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