| Title |
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
|
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
|
Initiation and Engagement of Substance Use Disorder Treatment
|
| CMS eCQM ID |
CMS137v9
|
CMS137v10
|
CMS137v11
|
| NQF Number |
Not Applicable
|
Not Applicable
|
Not Applicable
|
| Description |
Percentage of patients 13 years of age and older with a new episode of alcohol or other drug abuse or (AOD) dependence who received the following. Two rates are reported.
a. Percentage of patients who initiated treatment including either an intervention or medication for the treatment of AOD abuse or dependence within 14 days of the diagnosis
b. Percentage of patients who engaged in ongoing treatment including two additional interventions or a medication for the treatment of AOD abuse or dependence within 34 days of the initiation visit. For patients who initiated treatment with a medication, at least one of the two engagement events must be a treatment intervention.
|
Percentage of patients 13 years of age and older with a new episode of alcohol or other drug abuse or (AOD) dependence who received the following. Two rates are reported.
a. Percentage of patients who initiated treatment including either an intervention or medication for the treatment of AOD abuse or dependence within 14 days of the diagnosis
b. Percentage of patients who engaged in ongoing treatment including two additional interventions or a medication for the treatment of AOD abuse or dependence within 34 days of the initiation visit. For patients who initiated treatment with a medication, at least one of the two engagement events must be a treatment intervention.
|
Percentage of patients 13 years of age and older with a new substance use disorder (SUD) episode who received the following (Two rates are reported):
a. Percentage of patients who initiated treatment, including either an intervention or medication for the treatment of SUD, within 14 days of the new SUD episode.
b. Percentage of patients who engaged in ongoing treatment, including two additional interventions or short-term medications, or one long-term medication for the treatment of SUD, within 34 days of the initiation.
|
| Initial Population |
Patients age 13 years of age and older who were diagnosed with a new episode of alcohol, opioid, or other drug abuse or dependency during a visit between January 1 and November 14 of the measurement period
|
Patients age 13 years of age and older who were diagnosed with a new episode of alcohol, opioid, or other drug abuse or dependency during a visit between January 1 and November 14 of the measurement period
|
Patients age 13 years of age and older as of the start of the measurement period who were diagnosed with a new SUD episode during a visit between January 1 and November 14 of the measurement period
|
| Denominator |
Equals Initial Population
|
Equals Initial Population
|
Equals Initial Population
|
| Denominator Exclusions |
Exclude patients with a previous active diagnosis of alcohol, opioid or other drug abuse or dependence in the 60 days prior to the first episode of alcohol or drug dependence.
Exclude patients whose hospice care overlaps the measurement period.
|
Exclude patients with a negative diagnosis history, defined as an encounter or medication treatment for a diagnosis of alcohol, opioid or other drug abuse or dependence in the 60 days prior to the first episode of alcohol or drug dependence.
Exclude patients who are in hospice care for any part of the measurement period.
|
Exclude patients who are in hospice care for any part of the measurement period
|
| Numerator |
Numerator 1: Initiation of treatment includes either an intervention or medication for the treatment of AOD abuse or dependence within 14 days of the diagnosis.
Numerator 2: Engagement in ongoing treatment includes two additional interventions or a medication for the treatment of AOD abuse or dependence within 34 days of the initiation visit. For patients who initiated treatment with a medication, at least one of the two engagement events must be a treatment intervention (i.e., engagement for these members cannot be satisfied with medication treatment alone).
|
Numerator 1: Initiation of treatment includes either an intervention or medication for the treatment of AOD abuse or dependence within 14 days of the diagnosis.
Numerator 2: Engagement in ongoing treatment within 34 days of initiation includes:
1. Patients that initiated treatment with a psychosocial visit, and whose engagement criteria was fulfilled by a dispensed medication.
2. Patients that initiated treatment with a psychosocial visit, and whose engagement criteria was fulfilled by two further psychosocial visits.
3. Patients that initiated treatment with a dispensed medication, and whose engagement criteria was fulfilled by both a further medication dispense and a psychosocial visit.
4. Patients that initiated treatment with a dispensed medication, and whose engagement criteria was fulfilled by two psychosocial visits.
|
Numerator 1: Initiation of treatment includes either an intervention or medication for the treatment of SUD within 14 days of the new SUD episode
Numerator 2: Engagement in ongoing SUD treatment within 34 days of initiation includes:
1. A long-acting SUD medication on the day after the initiation through 34 days after the initiation of treatment
2. One of the following options on the day after the initiation of treatment through 34 days after the initiation of treatment: a) two engagement visits, b) two engagement medication treatment events, c) one engagement visit and one engagement medication treatment event
|
| Numerator Exclusions |
Not Applicable
|
Not Applicable
|
Not Applicable
|
| Denominator Exceptions |
None
|
None
|
None
|
| Measure Steward |
National Committee for Quality Assurance
|
National Committee for Quality Assurance
|
National Committee for Quality Assurance
|
| Quality Domain |
Effective Clinical Care
|
Effective Clinical Care
|
Effective Clinical Care
|
| Measure Scoring |
Proportion measure
|
Proportion measure
|
Proportion measure
|
| Measure Type |
Process measure
|
Process measure
|
Process measure
|
| Improvement Notation |
Higher score indicates better quality
|
Higher score indicates better quality
|
Higher score indicates better quality
|
| Guidance |
The new episode of alcohol and other drug dependence should be the first episode of the measurement period that is not preceded in the 60 days prior by another episode of alcohol or other drug dependence.
This eCQM is a patient-based measure.
This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM.
|
The new episode of alcohol and other drug dependence should be the first episode of the measurement period that is not preceded in the 60 days prior by another episode of alcohol or other drug dependence.
This eCQM is a patient-based measure.
This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM.
|
This eCQM is a patient-based measure.
This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.
|
| MIPS Quality ID |
305
|
305
|
305
|
| Meaningful Measure |
Prevention and Treatment of Opioid and Substance Use Disorders
|
Prevention and Treatment of Opioid and Substance Use Disorders
|
Prevention and Treatment of Opioid and Substance Use Disorders
|
| Telehealth Eligible |
Yes
|
Yes
|
Yes
|
| Next Version |
CMS137v10
|
CMS137v11
|
No Version Available
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| Previous Version |
No Version Available
|
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