Back to top
Top

Closing the Referral Loop: Receipt of Specialist Report

General eCQM Information

CMS Measure ID CMS50v10
NQF Number Not Applicable
Measure Description

Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred

Initial Population Number of patients, regardless of age, who had a visit during the measurement period and were referred by one provider to another provider
Denominator Statement

Equals Initial Population

Denominator Exclusions

None

Numerator Statement

Number of patients with a referral, for which the referring provider received a report from the provider to whom the patient was referred

Numerator Exclusions

Not Applicable

Denominator Exceptions

None

Measure Steward Centers for Medicare & Medicaid Services (CMS)
Domain Communication and Care Coordination
Measure Scoring Proportion
Measure Type Process
Improvement Notation

A higher score indicates better quality

Guidance

The provider who refers the patient to another provider is the provider who should be held accountable for the performance of this measure.

The provider to whom the patient was referred should be the same provider that sends the report.

If there are multiple referrals for a patient during the measurement period, use the first referral.

The provider to whom the patient was referred is responsible for sending the consultant report that will fulfill the communication. Note: this is not the same provider who would report on the measure.

The consultant report that will successfully close the referral loop should be related to the first referral for a patient during the measurement period. If there are multiple consultant reports received by the referring provider which pertain to a particular referral, use the first consultant report to satisfy the measure. Eligible professionals or eligible clinicians reporting on this measure should note that all data for the reporting year is to be submitted by the deadline established by CMS. Therefore, eligible professionals or eligible clinicians who refer patients towards the end of the reporting period (i.e., November - December), should request that providers to whom they referred their patients share their consult reports as soon as possible in order for those patients to be counted in the measure numerator during the measurement period. When providers to whom patients are referred communicate the consult report as soon as possible with the referring providers, it ensures that the communication loop is closed in a timely manner and that the data are included in the submission to CMS.

This eCQM is a patient-based measure.

This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM.

Quality ID 374
Meaningful Measure Transfer of Health Information and Interoperability
Telehealth Eligible Yes
Previous Version

Release Notes

Header

  • Updated the eCQM version number.

    Measure Section: eCQM Version Number

    Source of Change: Annual Update

  • 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

  • Modified the Stille reference in the rationale to align with APA in-text citation guidelines.

    Measure Section: Rationale

    Source of Change: Measure Lead

  • Revised the guidance to aid implementation by clarifying who is responsible for reporting the measure and the clinical actions required.

    Measure Section: Guidance

    Source of Change: ONC Project Tracking System (Jira): CQM-4138

  • Revised initial population statement language to promote readability.

    Measure Section: Initial Population

    Source of Change: Annual Update

  • Removed extraneous comma in Supplemental Data Elements field.

    Measure Section: Supplemental Data Elements

    Source of Change: Annual Update

Logic

  • Added a return clause to the 'Intervention, Performed': 'Referral' portion of the First Referral during Measurement Period definition to enable passing of consistent information to identify the first referral.

    Measure Section: Definitions

    Source of Change: Annual Update

  • Updated the attributes identified with the first referral in the Referring Provider Receives Consultant Report to Close Referral Loop definition to align with those described in the First Referral during Measurement Period definition.

    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

  • 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

  • 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.

  • Value set Consultant Report (2.16.840.1.113883.3.464.1003.121.12.1006): Added 14 LOINC codes based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

Last Updated: Jul 08, 2021