Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

Last updated: May 4, 2017

CMS Measure ID: CMS137v4
Version: 4
NQF Number: 0004
Measure Description:

Percentage of patients 13 years of age and older with a new episode of alcohol and other drug (AOD) dependence who received the following. Two rates are reported.

  • Percentage of patients who initiated treatment within 14 days of the diagnosis.
  • Percentage of patients who initiated treatment and who had two or more additional services with an AOD diagnosis within 30 days of the initiation visit.
Initial Patient Population:

Patients age 13 years of age and older who were diagnosed with a new episode of alcohol or drug dependency during a visit in the first 11 months of the measurement period

Denominator Statement:

Equals Initial Population

Denominator Exclusions:

Patients with a previous active diagnosis of alcohol or drug dependence in the 60 days prior to the first episode of alcohol or drug dependence

Numerator Statement:

Numerator 1: Patients who initiated treatment within 14 days of the diagnosis

Numerator 2: Patients who initiated treatment and who had two or more additional services with an AOD diagnosis within 30 days of the initiation visit

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: National Committee for Quality Assurance
Domain: Effective Clinical Care
Next Version: Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
Previous Version: Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
Measure Score: Proportion
Improvement Notation:

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.

Specifications

Release Notes

Header

  • Copyright updated.
  • Disclaimer updated.
  • eMeasure version number incremented.
  • eMeasure version number incremented from 4.0.000 to 4.1.000.

Logic

  • Introduced function 'satisfies all' to specify that qualifying events must meet all conditions from a set of conditions or 'satisfies any' to specify that qualifying events must meet at least one condition from a set of conditions to streamline expression logic.
  • Introduced occurrencing on variables to enforce that the same instance of a clinical event is used throughout the measure when the logic within the variable does not limit the event to a single instance, e.g., FIRST or MOST RECENT.
  • Introduced variables $FirstAlcoholDrugDependenceDx and $DrugDependenceTreatmentOrPsychVisit to allow re-use of logical expressions and reduce redundancy/complexity.
  • Replaced 'ORs' with 'Union of' operator to provide a mechanism for specifying that qualifying event(s) must be a member of at least one of the data elements being unioned (if appropriate for measure intent).
  • Replaced 'Patient Characteristic Birthdate' with 'Age at' operator.
  • The top level logical operator for the Numerator Exclusions, Denominator Exclusions, Denominator Exceptions, and Measure Population Exclusions defaults to 'OR'.

Value Sets

  • Value set Alcohol and Drug Dependence (OID 2.16.840.1.113883.3.464.1003.106.12.1001): Added 7 SNOMED codes (110281001, 125851000119106, 153491000119103, 19303008, 6525002, 91388009, 95918004) and deleted 29 SNOMED codes.

XML

  • This measure contains multiple Population Criteria sections. The earlier version of this measure contained mismatches between the applicable Population Criteria human readable narrative sections and their associated computer-readable sections in the XML file. This issue has been corrected.

External Resources