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Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)

Compare Versions of: "Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)"

The Compare function compares two years of the measure specifications found in the header of the measure's HTML. It does not include a comparison of any information in the body of the HTML, e.g., population criteria, Clinical Quality Language, or value sets.

Strikethrough text highlighted in red indicates information changed from the previous version. Text highlighted in green indicates information updated in the new eCQM version.

Compare 2024 version to

Table Options
Measure Information 2024 Performance Period
Title Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)
CMS eCQM ID CMS135v12
CBE ID* 0081e
MIPS Quality ID 005
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 ACE inhibitor or ARB or ARNI therapy during the measurement period

Measure Scoring Proportion measure
Measure Type Process
Stratification

None

Risk Adjustment

None

Rationale

Use of ACE inhibitor, ARB, or ARNI therapy has been associated with improved outcomes in patients with reduced LVEF. Long-term therapy with ARBs have also been shown to reduce morbidity and mortality, especially in ACE inhibitor–intolerant patients. More recently, ARNI therapy has also...

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Clinical Recommendation Statement

In patients with Heart Failure with Reduced Ejection Fraction (HFrEF) and New York Heart Association (NYHA) class II to III symptoms, the use of ARNI is recommended to reduce morbidity and mortality (Class I, Level of Evidence A) (ACC/AHA/HFSA, 2022).

In patients with previous or current...

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Improvement Notation

Higher score indicates better quality

Definition

Prescribed - prescription given to the patient for ACE inhibitor or ARB or ARNI therapy at one or more visits in the measurement period OR patient already taking ACE inhibitor or ARB or ARNI therapy as documented in current medication list.

LVEF <=40% corresponds to qualitative...

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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.

The requirement of two or more visits is used to establish that the eligible professional or eligible clinician has an...

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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 ACE inhibitor or ARB or ARNI therapy during the measurement period

Numerator Exclusions

Not Applicable

Denominator Exceptions

Documentation of medical reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., pregnancy, renal failure due to ACEI, allergy, intolerance, other medical reasons).

Documentation of patient reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., patient...

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Telehealth Eligible Yes
Next Version
Previous Version

Header

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated disclaimer.

    Measure Section: Disclaimer

    Source of Change: Annual Update

  • Updated Clinical Recommendation Statement to align with current heart failure guidelines.

    Measure Section: Clinical Recommendation Statement

    Source of Change: Measure Lead

  • Updated references.

    Measure Section: Reference

    Source of Change: Measure Lead

  • Updated grammar, wording, and/or formatting to improve readability and consistency.

    Measure Section: Definition

    Source of Change: Annual Update

  • Updated grammar, wording, and/or formatting to improve readability and consistency.

    Measure Section: Guidance

    Source of Change: Annual Update

  • Added guidance to clarify the options for capturing Ejection Fraction results to meet measure requirements.

    Measure Section: Guidance

    Source of Change: Measure Lead

Logic

  • Updated Initial Population logic to ensure two distinct encounters are captured to satisfy the two qualifying encounters requirement and better align with measure intent.

    Measure Section: Initial Population

    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

  • Added 'day of' specificity to definitions to harmonize with other measures and to align with the CQL Style Guide.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Applied a new shared CQL library, 'HFCommonDefinitions', to reduce duplication of common definitions between heart failure related eCQMs.

    Measure Section: Definitions

    Source of Change: Measure Lead

Value Set

The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.

  • Deleted direct reference code RxNorm code (1656328) based on applicability of value set and/or OID.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set (2.16.840.1.113883.3.526.3.1489): Renamed to ACE Inhibitor or ARB or ARNI Ingredient based on recommended value set naming conventions.

    Measure Section: Terminology

    Source of Change: Annual Update

  • 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 (2.16.840.1.113762.1.4.1178.56): Renamed to Heart Transplant Complications based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set (2.16.840.1.113762.1.4.1178.58): Renamed to Left Ventricular Assist Device Complications based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Left Ventricular Assist Device Placement (2.16.840.1.113762.1.4.1178.61): Added 1 SNOMED CT code (700151002) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Patient Reason (2.16.840.1.113883.3.526.3.1008): Deleted 3 SNOMED CT codes (183944003, 413310006, 413312003) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • 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

  • Value set Pregnancy (2.16.840.1.113883.3.526.3.378): Added 175 ICD-10-CM codes based on terminology update. Deleted 14 ICD-10-CM codes based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

Last Updated: Jun 03, 2024