Functional Status Assessments for Heart Failure
Compare Versions of: "Functional Status Assessments for Heart Failure"
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| Measure Information | 2022 Performance Period | 2023 Performance Period | 2024 Performance Period |
|---|---|---|---|
| Title | Functional Status Assessments for Heart Failure | Functional Status Assessments for Heart Failure | Functional Status Assessments for Heart Failure |
| CMS eCQM ID | CMS90v11 | CMS90v12 | CMS90v13 |
| CBE ID | Not Applicable | Not Applicable | Not Applicable |
| MIPS Quality ID | 377 | 377 | 377 |
| Measure Steward | Centers for Medicare & Medicaid Services (CMS) | Centers for Medicare & Medicaid Services (CMS) | Centers for Medicare & Medicaid Services (CMS) |
| Description |
Percentage of patients 18 years of age and older with heart failure who completed initial and follow-up patient-reported functional status assessments |
Percentage of patients 18 years of age and older with heart failure who completed initial and follow-up patient-reported functional status assessments |
Percentage of patients 18 years of age and older with heart failure who completed initial and follow-up patient-reported functional status assessments |
| Measure Scoring | Proportion measure | Proportion measure | Proportion measure |
| Measure Type | Process measure | Process measure | Process measure |
| Stratification | *See CMS90v11.html | *See CMS90v12.html |
None |
| Risk Adjustment | *See CMS90v11.html | *See CMS90v12.html |
None |
| Rationale | *See CMS90v11.html | *See CMS90v12.html |
Patients living with heart failure often have poor functional status and health-related quality of life, which declines as the disease progresses (Allen et al., 2012). In addition, their care is often complicated by multiple comorbidities. To assist in managing these complex patients, the American College of Cardiology Foundation and American Heart Association recommend collecting initial and repeat assessments of a patient's function and ability to complete desired activities of daily living (Hunt et al., 2009). The American Heart Association has also released scientific statements emphasizing the collection of patient-reported health status (for example, functional limitations, symptom burden, quality of life) from heart failure patients as an important means of establishing a dynamic conversation between patient and provider regarding care goals and the patient's priorities (Allen et al., 2012; Rumsfeld et al., 2013). |
| Clinical Recommendation Statement | *See CMS90v11.html | *See CMS90v12.html |
American College of Cardiology Foundation and American Heart Association (2013): While this guideline does not explicitly recommend the use of patient-reported functional status or quality of life assessments (such as the Kansas City Cardiomyopathy Questionnaire or Minnesota Living with Heart Failure Questionnaire), it does “refer to meaningful survival as a state in which HRQOL [health-related quality of life] is satisfactory to the patient.” The guideline also includes quality of life assessments in its description of a detailed plan of care for patients with chronic heart failure. |
| Improvement Notation |
A higher score indicates better quality |
A higher score indicates better quality |
A higher score indicates better quality |
| Definition | *See CMS90v11.html | *See CMS90v12.html |
None |
| Guidance |
Initial functional status assessment (FSA) and encounter: The initial FSA is an FSA that occurs two weeks before or during an encounter, in the 180 days or more before the end of the measurement period. Follow-up FSA: The follow-up FSA must be completed at least 30 days but no more than 180 days after the initial FSA. The same FSA instrument must be used for the initial and follow-up assessment. 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. |
Initial functional status assessment (FSA) and encounter: The initial FSA is an FSA that occurs within two weeks before or during an encounter, in the 180 days or more before the end of the measurement period. Follow-up FSA: The follow-up FSA must be completed at least 30 days but no more than 180 days after the initial FSA. The same FSA instrument must be used for the initial and follow-up assessment. 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. |
Initial functional status assessment (FSA) and encounter: The initial FSA is an FSA that occurs within two weeks before or during an encounter, in the 180 days or more before the end of the measurement period. Follow-up FSA: The follow-up FSA must be completed at least 30 days but no more than 180 days after the initial FSA. The same FSA instrument must be used for the initial and follow-up assessment. 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. |
| Initial Population |
Patients 18 years of age and older who had two outpatient encounters during the measurement period and a diagnosis of heart failure that starts before and continues into the measurement period. |
Patients 18 years of age and older who had two outpatient encounters during the measurement period and a diagnosis of heart failure that starts any time before and continues into the measurement period. |
Patients 18 years of age and older who had two outpatient encounters during the measurement period and a diagnosis of heart failure that starts any time before and continues into the measurement period. |
| Denominator |
Equals Initial Population |
Equals Initial Population |
Equals Initial Population |
| Denominator Exclusions |
Exclude patients with severe cognitive impairment in any part of the measurement period. Exclude patients who are in hospice care for any part of the measurement period. |
Exclude patients with severe cognitive impairment in any part of the measurement period. Exclude patients who are in hospice care for any part of the measurement period. |
Exclude patients with severe cognitive impairment in any part of the measurement period. Exclude patients who are in hospice care for any part of the measurement period. |
| Numerator |
Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12]; VR-36; Kansas City Cardiomyopathy Questionnaire [KCCQ]; KCCQ-12; Minnesota Living with Heart Failure Questionnaire [MLHFQ]; Patient-Reported Outcomes Measurement Information System [PROMIS]-10 Global Health, PROMIS-29) present in the EHR two weeks before or during the initial FSA encounter and results for the follow-up FSA at least 30 days but no more than 180 days after the initial FSA |
Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12]; VR-36; Kansas City Cardiomyopathy Questionnaire [KCCQ]; KCCQ-12; Minnesota Living with Heart Failure Questionnaire [MLHFQ]; Patient-Reported Outcomes Measurement Information System [PROMIS]-10 Global Health, PROMIS-29) present in the EHR within two weeks before or during the initial FSA encounter and results for the follow-up FSA at least 30 days but no more than 180 days after the initial FSA |
Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12]; VR-36; Kansas City Cardiomyopathy Questionnaire [KCCQ]; KCCQ-12; Minnesota Living with Heart Failure Questionnaire [MLHFQ]; Patient-Reported Outcomes Measurement Information System [PROMIS]-10 Global Health; PROMIS-29) present in the EHR within two weeks before or during the initial FSA encounter and results for the follow-up FSA at least 30 days but no more than 180 days after the initial FSA |
| Numerator Exclusions |
Not Applicable |
Not Applicable |
Not Applicable |
| Denominator Exceptions |
None |
None |
None |
| Telehealth Eligible | Yes | Yes | Yes |
| Next Version | No Version Available | ||
| Previous Version | No Version Available |
Header
Updated copyright.
Measure Section: Copyright
Source of Change: Annual Update
Updated grammar, wording, and/or formatting to improve readability and consistency.
Measure Section: Clinical Recommendation Statement
Source of Change: Annual Update
Updated grammar, wording, and/or formatting to improve readability and consistency.
Measure Section: Numerator
Source of Change: Annual Update
Logic
Replaced direct reference code used to identify patients with severe cognitive impairment to align with measure intent.
Measure Section: Denominator Exclusions
Source of Change: Measure Lead
Updated the version number of the Hospice Library to v5.0.000.
Measure Section: Definitions
Source of Change: Annual Update
Added QDM datatype 'Diagnosis' to the Hospice.'Has Hospice Services' definition referencing a new value set containing SNOMED finding codes to provide an additional approach for identifying patients receiving hospice care.
Measure Section: Definitions
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: Definitions
Source of Change: Standards/Technical Update
Updated the timing comparison precision in the definitions from datetime to date by adding 'day of' or 'date from' to align with the measure intent and harmonize timings across similar eCQMs.
Measure Section: Definitions
Source of Change: Measure Lead
Added 'day of' specificity to hospice expressions for consistency.
Measure Section: Definitions
Source of Change: Measure Lead
Updated the version number of the Hospice Library to v5.0.000.
Measure Section: Functions
Source of Change: Annual 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.
Replaced direct reference code SNOMED CT code (428351000124105) with direct reference code SNOMED CT code (702956004) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Heart Failure (2.16.840.1.113883.3.526.3.376): Added 5 SNOMED CT codes (1204200007, 1204203009, 1204204003, 1204206001, 1204462004) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
Value set Hospice Care Ambulatory (2.16.840.1.113883.3.526.3.1584): Deleted 3 SNOMED CT codes (170935008, 170936009, 305911006) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Hospice Diagnosis (2.16.840.1.113883.3.464.1003.1165) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Hospice Encounter (2.16.840.1.113883.3.464.1003.1003): Added 2 SNOMED CT codes (305911006, 385765002) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Online Assessments (2.16.840.1.113883.3.464.1003.101.12.1089): Added 4 CPT codes (98980, 98981, 99444, 99457) based on review by technical experts, SMEs, and/or public feedback. Added 3 HCPCS codes (G2250, G2251, G2252) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Payer (2.16.840.1.114222.4.11.3591): Added 5 SOP codes (1111, 1112, 142, 344, 141) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead