Measure Information | 2022 Performance Period |
---|---|
CMS eCQM ID | CMS144v10 |
NQF Number | 0083e |
MIPS Quality ID | 008 |
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 beta-blocker therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge |
Initial Population |
All patients aged 18 years and older with a diagnosis of heart failure |
Numerator |
Patients who were prescribed beta-blocker therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge |
Numerator Exclusions |
Not Applicable |
Denominator |
Equals Initial Population with a current or prior LVEF < 40% |
Denominator Exclusions |
None |
Denominator Exceptions |
Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons). Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons). Documentation of system reason(s) for not prescribing beta-blocker therapy (e.g., other reasons attributable to the healthcare system). |
Steward | American Heart Association-American Stroke Association |
Measure Scoring | Proportion measure |
Measure Type | Process measure |
Improvement Notation |
Higher score indicates better quality |
Guidance |
This eCQM is to be reported as patient-based or episode-based, depending on the clinical setting. To satisfy this measure, it must be reported for all heart failure patients at least once during the measurement period if seen in the outpatient setting. If the patient has an eligible inpatient discharge during the measurement period, as defined in the measure logic, it is expected to be reported at each hospital discharge. A range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly meets the less than 40% threshold noted in the denominator logic. A range that is inclusive of or greater than 40% would not meet the measure requirement. Beta-blocker therapy: -For patients with prior LVEF < 40%, beta-blocker therapy should include bisoprolol, carvedilol, or sustained release metoprolol succinate. The requirement of two or more visits used in Population Criteria 1 is to establish that the eligible professional or eligible clinician has an existing relationship with the patient. This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM. |
Telehealth Eligible | Yes |
Next Version | |
Previous Version |
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Measure Information | 2021 Performance Period | 2022 Performance Period | 2023 Performance Period | 2024 Performance Period |
---|---|---|---|---|
Title | Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) | Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) | Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) | Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) |
CMS eCQM ID | CMS144v9 | CMS144v10 | CMS144v11 | CMS144v12 |
NQF Number | 0083e | 0083e | 0083e | 0083e |
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 beta-blocker therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge |
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 beta-blocker therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge |
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 |
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 |
Initial Population |
All patients aged 18 years and older with a diagnosis of heart failure |
All patients aged 18 years and older with a diagnosis of heart failure |
All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of heart failure |
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% |
Equals Initial Population with a current or prior LVEF < 40% |
Equals Initial Population with a current or prior LVEF <= 40% |
Equals Initial Population with a current or prior LVEF <= 40% |
Denominator Exclusions | None | None | 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 | 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 beta-blocker therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge |
Patients who were prescribed beta-blocker therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge |
Patients who were prescribed or already taking beta-blocker therapy during the measurement period |
Patients who were prescribed or already taking beta-blocker therapy during the measurement period |
Numerator Exclusions |
Not Applicable |
Not Applicable |
Not Applicable |
Not Applicable |
Denominator Exceptions |
Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons). Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons). Documentation of system reason(s) for not prescribing beta-blocker therapy (e.g., other reasons attributable to the healthcare system). |
Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons). Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons). Documentation of system reason(s) for not prescribing beta-blocker therapy (e.g., other reasons attributable to the healthcare system). |
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). Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons) |
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). Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons). |
Measure Steward | PCPI(R) Foundation (PCPI[R]) | American Heart Association-American Stroke Association | American Heart Association | American Heart Association |
Measure Scoring | Proportion measure | Proportion measure | Proportion measure | Proportion measure |
Measure Type | Process measure | Process measure | Process measure | Process measure |
Improvement Notation |
Higher score indicates better quality |
Higher score indicates better quality |
Higher score indicates better quality |
Higher score indicates better quality |
Guidance |
This eCQM is to be reported as patient-based or episode-based, depending on the clinical setting. To satisfy this measure, it must be reported for all heart failure patients at least once during the measurement period if seen in the outpatient setting. If the patient has an eligible inpatient discharge during the measurement period, as defined in the measure logic, it is expected to be reported at each hospital discharge. A range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly meets the less than 40% threshold noted in the denominator logic. A range that is inclusive of or greater than 40% would not meet the measure requirement. Beta-blocker therapy: -For patients with prior LVEF < 40%, beta-blocker therapy should include bisoprolol, carvedilol, or sustained release metoprolol succinate. The requirement of two or more visits used in Population Criteria 1 is to establish that the eligible professional or eligible clinician has an existing relationship with the patient. 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 to be reported as patient-based or episode-based, depending on the clinical setting. To satisfy this measure, it must be reported for all heart failure patients at least once during the measurement period if seen in the outpatient setting. If the patient has an eligible inpatient discharge during the measurement period, as defined in the measure logic, it is expected to be reported at each hospital discharge. A range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly meets the less than 40% threshold noted in the denominator logic. A range that is inclusive of or greater than 40% would not meet the measure requirement. Beta-blocker therapy: -For patients with prior LVEF < 40%, beta-blocker therapy should include bisoprolol, carvedilol, or sustained release metoprolol succinate. The requirement of two or more visits used in Population Criteria 1 is to establish that the eligible professional or eligible clinician has an existing relationship with the patient. 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 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 meets the less than or equal to 40% threshold noted in the denominator logic. A range that is greater than 40% would not meet the measure requirement. Beta-blocker therapy: -For patients with prior LVEF <= 40%, beta-blocker therapy should include bisoprolol, carvedilol, or sustained release metoprolol succinate. The requirement of two or more visits is to establish that the eligible professional or eligible clinician has an existing relationship with the patient. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM. |
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 meets the less than or equal to 40% threshold noted in the denominator logic. A range that is greater than 40% would not meet the measure requirement. In order for the Ejection Fraction result pathway to be recognized as below 40%, the result must be reported as a number with unit of %. A text string of "below 40%" or "ejection fraction between 35 and 40%" will not be recognized through electronic data capture. Although, this criteria can also be met using the Diagnosis pathway if specified as "Moderate or Severe." Beta-blocker therapy: -For patients with prior LVEF <= 40%, beta-blocker therapy should include bisoprolol, carvedilol, or sustained release metoprolol succinate. The requirement of two or more visits is to establish that the eligible professional or eligible clinician has an existing relationship with the patient. 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 | 008 | 008 | 008 | 008 |
Telehealth Eligible | Yes | Yes | Yes | Yes |
Next Version | CMS144v10 | CMS144v11 | CMS144v12 | No Version Available |
Previous Version | No Version Available |
Data Element Repository
Header
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Updated the eCQM version number.
Measure Section: eCQM Version Number
Source of Change: Annual Update
-
Updated Measure Steward.
Measure Section: Measure Steward
Source of Change: Measure Lead
-
Updated Measure Developer.
Measure Section: Measure Developer
Source of Change: Measure Lead
-
Updated copyright.
Measure Section: Copyright
Source of Change: Annual Update
-
Updated disclaimer.
Measure Section: Disclaimer
Source of Change: Annual Update
-
Updated references.
Measure Section: Reference
Source of Change: Annual Update
-
Updated definition pertaining to Moderate to Severe LVSD to better align with logic.
Measure Section: Definition
Source of Change: Annual Update
Logic
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Updated the Heart Failure Outpatient Encounter with Moderate or Severe LVSD and Heart Failure Inpatient Encounter with Moderate or Severe LVSD denominator definitions' timing from before to starts before to align timing with intent.
Measure Section: Denominator
Source of Change: Annual Update
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Removed Medication, Active from Population 2 numerator definition to align with standard capture of discharge medications.
Measure Section: Numerator
Source of Change: Annual Update
-
Updated timing logic so that cardiac pacers in existence before the index encounter are considered for the denominator exception.
Measure Section: Denominator Exceptions
Source of Change: ONC Project Tracking System (Jira): QRDA-964
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Updated Outpatient Encounter definitions to remove FaceToFaceEncounter language to signal broadening of encounter type.
Measure Section: Definitions
Source of Change: Annual Update
-
Updated the names of Clinical Quality Language (CQL) definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.
Measure Section: Multiple Sections
Source of Change: Standards Update
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Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library (MATGlobalCommonFunctions-6.2.000). Updated the 'Inpatient Encounter' definition to include a 'day of' timing clarification. Added the following timing functions: Normalize Interval, Has Start, Has End, Latest, Latest Of, Earliest, and Earliest Of. Please see individual measure details for application of specific timing functions.
Measure Section: Multiple Sections
Source of Change: Standards Update
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Added new NormalizeInterval function to timing attributes to decrease implementation burden due to variable use of timing attributes for select QDM data types. The NormalizeInterval function was applied, where applicable, for the following data elements: Assessment, Performed; Device, Applied; Diagnostic Study, Performed; Intervention, Performed; Laboratory Test, Performed; Medication, Administered; Medication, Dispensed; Physical Exam, Performed; Procedure, Performed; Substance, Administered.
Measure Section: Multiple Sections
Source of Change: Standards 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.
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Removed value set Left Ventricular Systolic Dysfunction (2.16.840.1.113883.3.526.3.1091) based on applicability of a single code to represent clinical data.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Atrioventricular Block (2.16.840.1.113883.3.526.3.367): Added 4 SNOMED CT codes (102451000119107, 204383001, 284941000119107, 733125004) based on review by technical experts, SMEs, and/or public feedback. Added 3 ICD-10-CM codes (I44.0, I44.30, I44.39) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
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Value set Cardiac Pacer in Situ (2.16.840.1.113883.3.526.3.368): Added 1 ICD-10-CM code (Z95.810) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
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Value set Heart Failure (2.16.840.1.113883.3.526.3.376): Added 1 SNOMED CT code (871617000) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
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Replaced value set Left Ventricular Systolic Dysfunction (2.16.840.1.113883.3.526.2.859) with direct reference code SNOMED CT code (134401001) based on applicability of a single code to represent clinical data.
Measure Section: Terminology
Source of Change: Annual Update