Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)
Compare Versions of: "Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)"
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Compare 2023 version to
Measure Information | 2023 Performance Period |
---|---|
Title | Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) |
CMS eCQM ID | CMS144v11 |
CBE ID* | 0083e |
MIPS Quality ID | 008 |
Measure Steward | American Heart Association |
Description |
Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) <= 40% who were prescribed or already taking beta-blocker therapy during the measurement period |
Measure Scoring | Proportion measure |
Measure Type | Process |
Stratification | *See CMS144v11.html |
Risk Adjustment | *See CMS144v11.html |
Rationale | *See CMS144v11.html |
Clinical Recommendation Statement | *See CMS144v11.html |
Improvement Notation |
Higher score indicates better quality |
Definition | *See CMS144v11.html |
Guidance | This eCQM is to be reported as patient-based. To satisfy this measure, it must be reported for all heart failure patients at least once during the measurement period. A range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly...Show more > |
Initial Population |
All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of heart failure |
Denominator |
Equals Initial Population with a current or prior LVEF <= 40% |
Denominator Exclusions |
Patients with a history of heart transplant or with a Left Ventricular Assist Device (LVAD) prior to the end of the outpatient encounter with Moderate or Severe LVSD |
Numerator |
Patients who were prescribed or already taking beta-blocker therapy during the measurement period |
Numerator Exclusions |
Not Applicable |
Denominator Exceptions | Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., arrhythmia, asthma, bradycardia, hypotension, patients with atrioventricular block without cardiac pacer, observation of consecutive heart rates <50, allergy, intolerance, other medical reasons). Documentat...Show more > |
Telehealth Eligible | Yes |
Next Version | |
Previous Version | No Version Available |
Additional Resources for CMS144v11
Header
Updated name of measure steward.
Measure Section: Measure Steward
Source of Change: Measure Lead
Updated copyright.
Measure Section: Copyright
Source of Change: Annual Update
Updated disclaimer.
Measure Section: Disclaimer
Source of Change: Standards/Technical Update
Updated rationale to align with most recent guidelines.
Measure Section: Rationale
Source of Change: Measure Lead
Update clinical recommendation statement to align with most recent guidelines.
Measure Section: Clinical Recommendation Statement
Source of Change: Measure Lead
Updated references.
Measure Section: Reference
Source of Change: Measure Lead
Updated version number of the Quality Data Model (QDM) used in the measure specification to v5.6.
Measure Section: Guidance
Source of Change: Standards/Technical Update
Updated initial population statement to align with measure logic requiring at least two qualifying encounters.
Measure Section: Initial Population
Source of Change: Measure Lead
Updated the denominator statement to include patients with a left ventricular ejection fraction (LVEF) less than or equal to 40% to align with clinical guidelines.
Measure Section: Denominator
Source of Change: Measure Lead
Added denominator exclusions for patients with a history of heart transplant or with a Left Ventricular Assist Device (LVAD), because these patients were not included in clinical treatment trials for low LVEF heart failure.
Measure Section: Denominator Exclusions
Source of Change: Measure Lead
Updated the numerator statement to more closely align with measure logic.
Measure Section: Numerator
Source of Change: Measure Lead
Removed system reason denominator exception due to wide-availability of medications.
Measure Section: Denominator Exceptions
Source of Change: Measure Lead
Updated denominator exception statement to better align with specific medical conditions in the logic.
Measure Section: Denominator Exceptions
Source of Change: Measure Lead
Removed Population 2, the inpatient population, from the measure to address implementer feedback and keep measure intent contained to the outpatient setting.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Logic
Updated the logic to include an LVEF less than or equal to 40%, to align with clinical guidelines.
Measure Section: Denominator
Source of Change: Measure Lead
Added denominator exclusions to the logic excluding patients with a history of heart transplant or a Left Ventricular Assist Device (LVAD), heart transplant-related diagnoses, and LVAD-related diagnoses, because these patients were not included in clinical treatment trials for low LVEF heart failure.
Measure Section: Denominator Exclusions
Source of Change: Measure Lead
Removed system reason denominator exception due to wide-availability of medications.
Measure Section: Denominator Exceptions
Source of Change: Measure Lead
Replaced 'Device, Applied' with 'Procedure, Performed' in Cardiac Pacer Implanted expression to align with current QDM.
Measure Section: Denominator Exceptions
Source of Change: Measure Lead
Replaced timing operator 'overlaps after' with 'starts before end of' to allow use of 'NormalizeInterval' function, where applicable.
Measure Section: Denominator Exceptions
Source of Change: Measure Lead
Updated encounter logic definition name by adding 'History of' to align with intent of capturing patients with a history of left ventricular systolic dysfunction (LVSD).
Measure Section: Definitions
Source of Change: Measure Lead
Updated the version of the Quality Data Model (QDM) to 5.6 and Clinical Quality Language (CQL) to 1.5.
Measure Section: Multiple Sections
Source of Change: Standards/Technical Update
Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library to v7.0.000.
Measure Section: Multiple Sections
Source of Change: Standards/Technical Update
Removed Population 2, the inpatient population, from the measure to address implementer feedback and keep measure intent contained to the outpatient setting.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Replaced the Global.CalendarAgeInYearsAt function with the native CQL function AgeInYearsAt to take advantage of existing CQL features and increase human readability. As a result of this change, the LOINC code 21112-8 is no longer required and has been removed from the Terminology section of the human readable specification.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Added the 'NormalizeInterval' function to 'Procedure, Performed', 'Physical Exam, Performed', and 'Diagnosis' to decrease implementation burden due to variable use of timing attributes.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.
Measure Section: Multiple Sections
Source of Change: Standards/Technical Update
Value set
The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.
Value set Cardiac Pacer in Situ (2.16.840.1.113883.3.526.3.368): Added 1 SNOMED CT code (443325000) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Bradycardia (2.16.840.1.113883.3.526.3.412): Added 2 SNOMED CT codes (1142110005, 1142111009) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
Value set Beta Blocker Therapy for LVSD (2.16.840.1.113883.3.526.3.1184): Added 4 RxNorm codes (1999031, 1999033, 1999035, 1999037) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Beta Blocker Therapy Ingredient (2.16.840.1.113883.3.526.3.1493): Added 2 RxNorm codes (31555, 9947) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Asthma (2.16.840.1.113883.3.526.3.362): Added 1 SNOMED CT code (762521001) based on terminology update. Deleted 2 SNOMED CT codes (304527002, 708038006) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
Value set Arrhythmia (2.16.840.1.113883.3.526.3.366): Added 26 SNOMED CT codes based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
Value set Ejection Fraction (2.16.840.1.113883.3.526.3.1134): Added 3 LOINC codes (93644-3, 93645-0, 93646-8) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
Removed value set System Reason (2.16.840.1.113883.3.526.3.1009) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Removed value set Discharge Services - Hospital Inpatient (2.16.840.1.113883.3.464.1003.101.12.1007) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Left Ventricular Assist Device Placement (2.16.840.1.113762.1.4.1178.61) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Left Ventricular Assist Device Related Diagnoses (2.16.840.1.113762.1.4.1178.58) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Heart Transplant Related Diagnoses (2.16.840.1.113762.1.4.1178.56) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Heart Transplant (2.16.840.1.113762.1.4.1178.33) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Cardiac Pacer (2.16.840.1.113762.1.4.1178.53) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Medical Reason (2.16.840.1.113883.3.526.3.1007): Deleted 1 SNOMED CT code (397745006) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
Removed value set Cardiac Pacer (2.16.840.1.113883.3.526.3.1193) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Removed direct reference code LOINC code (21112-8) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead