eCQM Title

Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

eCQM Identifier (Measure Authoring Tool)

137

eCQM Version Number

9.3.000

NQF Number

Not Applicable

GUID

c3657d72-21b4-4675-820a-86c7fe293bf5

Measurement Period

January 1, 20XX through December 31, 20XX

Measure Steward

National Committee for Quality Assurance

Measure Developer

National Committee for Quality Assurance

Endorsed By

None

Description

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

a. Percentage of patients who initiated treatment including either an intervention or medication for the treatment of AOD abuse or dependence within 14 days of the diagnosis 
b. Percentage of patients who engaged in ongoing treatment including two additional interventions or a medication for the treatment of AOD abuse or dependence within 34 days of the initiation visit. For patients who initiated treatment with a medication, at least one of the two engagement events must be a treatment intervention.

This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2019 National Committee for Quality Assurance. All Rights Reserved.

Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third party codes contained in the specifications.

CPT(R) contained in the Measure specifications is copyright 2004-2019 American Medical Association. LOINC(R) copyright 2004-2019 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2019 International Health Terminology Standards Development Organisation. ICD-10 copyright 2019 World Health Organization. All Rights Reserved.

Disclaimer

The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.
 
Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].

Measure Scoring

Proportion

Measure Type

Process

Stratification

Report a total score, and each of the following strata:
Stratum 1: Patients age 13-17 at the end of the Measurement Period
Stratum 2: Patients age >=18  at the end of the Measurement Period

Risk Adjustment

None

Rate Aggregation

None

Rationale

There are more deaths, illnesses and disabilities from substance abuse than from any other preventable health condition. In 2017, 19.7 million individuals in the U.S. age 12 or older (approximately 8 percent of the population) were classified as having an SUD within the past year (SAMHSA, 2018). Despite the high prevalence of SUD in the U.S., only 20 percent of individuals with SUD receive any substance use treatment and only 13 percent receive treatment in a specialty SUD program (SAMHSA, 2018a).

Clinical Recommendation Statement

American Psychiatric Association (2018)
* Patients with alcohol use disorder should have a documented comprehensive and person-centered treatment plan that includes evidence-based nonpharmacological and pharmacological treatments. [1C]
* Naltrexone or acamprosate be offered to patients with moderate to severe alcohol use disorder who have a goal of reducing alcohol consumption or achieving abstinence, prefer pharmacotherapy or have not responded to nonpharmacological treatments alone, and have no contraindications to the use of these medications. [1B]
* Disulfiram should be offered to patients with moderate to severe alcohol use disorder who have a goal of achieving abstinence, prefer disulfiram or are intolerant to or have not responded to naltrexone and acamprosate, are capable of understanding the risks of alcohol consumption while taking disulfiram, and have no contraindications to the use of this medication. [2C]
* Topiramate or gabapentin be offered to patients with moderate to severe alcohol use disorder who have a goal of reducing alcohol consumption or achieving abstinence, prefer topiramate or gabapentin or are intolerant to or have not responded to naltrexone and acamprosate, and have no contraindications to the use of these medications. [2C]

American Psychiatric Association (2006)
* Because many substance use disorders are chronic, patients usually require long-term treatment, although the intensity and specific components of treatment may vary over time [I rating].
* It is important to intensify the monitoring for substance use during periods when the patient is at a high risk of relapsing, including during the early stages of treatment, times of transition to less intensive levels of care, and the first year after active treatment has ceased [I rating].
* Outpatient treatment of substance use disorders is appropriate for patients whose clinical condition or environmental circumstances do not require a more intensive level of care [I rating]. As in other treatment settings, a comprehensive approach is optimal, using, where indicated, a variety of psychotherapeutic and pharmacological interventions along with behavioral monitoring [I rating ].
* Disulfiram is also recommended for patients with alcohol dependence [II rating].
* Naltrexone, injectable naltrexone, acamprosate, a y-aminobutyric acid (GABA) are recommended for patients with alcohol dependence [I rating]. Disulfiram is also recommended for patients with alcohol dependence [II rating].
* Methadone and buprenorphine are recommended for patients with opioid dependence [I rating].
* Naltrexone is an alternative strategy [I rating].

American Society of Addiction Medicine (2015)
* Methadone and buprenorphine are recommended for opioid use disorder treatment and withdrawal management.
* Naltrexone (oral; extended-release injectable) is recommended for relapse prevention.

Michigan Quality Improvement Consortium (2017)
*Patients with substance use disorder or risky substance use: Patient Education and Brief Intervention by PCP or Trained Staff (e.g. RN, MSW)
*If diagnosed with substance use disorder or risky substance use, initiate an intervention within 14 days.
*Frequent follow-up is helpful to support behavior change; preferably 2 visits within 30 days.
*Refer to a substance abuse health specialist, an addiction physician specialist, or a physician experienced in pharmacologic management of addiction.

Department of Veterans Affairs/Department of Defense (2015)
* Offer referral to specialty SUD care for addiction treatment if based on willingness to engage. [B]
* For patients with moderate-severe alcohol use disorder, we recommend: Acamprosate, Disulfiram, Naltrexone- oral or extended release, or Topiramate. [A]
* Medications should be offered in combined with addiction-focused counseling. offering one or more of the following interventions considering patient preference and provider training/competence: Behavioral Couples Therapy for alcohol use disorder, Cognitive Behavioral Therapy for substance use disorders, Community Reinforcement Approach, Motivational Enhancement Therapy, 12-Step Facilitation. [A]
* For patients with opioid use disorder we recommend buprenorphine/naloxone or methadone in an Opioid Treatment Program. For patients for whom agonist treatment is contraindicated, unacceptable, unavailable, or discontinued, we recommend extended-release injectable naltrexone. [A]
* For patients initiated in an intensive phase of outpatient or residential treatment, recommend ongoing systematic relapse prevention efforts or recovery support, individualized on the basis of treatment response. [A]

Improvement Notation

Higher score indicates better quality

Reference

American Psychiatric Association: Work Group on Substance Use Disorders. (2006). Practice Guideline for the Treatment of Patients with Substance Use Disorders Second Edition. American Psychiatric Association (APA); 2006 Aug. 276 pg. [1789 references]. Retrieved from https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/substanceuse.pdf

Reference

Michigan Quality Improvement Consortium. (2017). Screening, diagnosis, and referral for substance use disorders. Southfield, (MI): Michigan Quality Improvement Consortium. Retrieved from http://www.mqic.org/pdf/mqic_screening_diagnosis_and_referral_for_substance_use_disorders_cpg.pdf

Reference

Schneider Institute for Health Policy, Brandeis University. 2001. Substance Abuse: The Nation's Number One Health Problem. Princeton: Robert Wood Johnson Foundation.

Reference

Department of Veteran Affairs, Department of Defense. (2015). VA/DoD Clinical Practice Guideline for the Management of Substance Use Disorders. Washington DC: Department of Veterans Affairs, Department of Defense.

Reference

Kampman, K., Jarvis, M. (2015). American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. Journal of Addiction Medicine; 9(5): 358–367. DOI: 10.1097/ADM.0000000000000166.

Reference

Pietras, S., M. Azur, J. Brown. 2015. Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use. (ASPE). Report prepared by Mathematica Policy Research for the U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation, Office of Disability, Aging and Long-Term Care Policy. https://aspe.hhs.gov/sites/default/files/pdf/205171/MATguidelines.pdf (November 16, 2016)

Reference

Reus, V. et al. (2018). Practice Guideline for the Pharmacological Treatment of Patients with Alcohol Use Disorder. American Journal of Psychiatry, 175(1), 86-90. doi:10.1176/appi.ajp.2017.1750101

Reference

Substance Abuse and Mental Health Services Administration (SAMHSA). 2018a. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health.” Retrieved from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHFFR2017/NSDUHFFR2017.htm#sud11

Definition

The initiation visit is the first visit for alcohol or other drug dependence treatment within 14 days after a diagnosis of alcohol or other drug dependence.

Treatment includes inpatient AOD admissions, outpatient visits, intensive outpatient encounters or partial hospitalization.

The Intake Period: January 1-November 14 of the measurement year. The Intake Period is used to capture new episodes of Alcohol or Drug Dependence. The November 14 cut-off date ensures that all services can occur before the measurement period ends.

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.

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.

Transmission Format

TBD

Initial Population

Patients age 13 years of age and older who were diagnosed with a new episode of alcohol, opioid, or other drug abuse or dependency during a visit between January 1 and November 14 of the measurement period

Denominator

Equals Initial Population

Denominator Exclusions

Exclude patients with a previous active diagnosis of alcohol, opioid or other drug abuse or dependence in the 60 days prior to the first episode of alcohol or drug dependence.

Exclude patients whose hospice care overlaps the measurement period.

Numerator

Numerator 1: Initiation of treatment includes either an intervention or medication for the treatment of AOD abuse or dependence within 14 days of the diagnosis. 

Numerator 2: Engagement in ongoing treatment includes two additional interventions or a medication for the treatment of AOD abuse or dependence within 34 days of the initiation visit. For patients who initiated treatment with a medication, at least one of the two engagement events must be a treatment intervention (i.e., engagement for these members cannot be satisfied with medication treatment alone).

Numerator Exclusions

Not Applicable

Denominator Exceptions

None

Supplemental Data Elements

For every patient evaluated by this measure also identify payer, race, ethnicity and sex

Population Criteria
Definitions
Functions
Terminology
Data Criteria (QDM Data Elements)
Supplemental Data Elements
Risk Adjustment Variables

Population Criteria

Population Criteria 1

Initial Population

exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
  where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 13
    and "First Dependence Diagnosis During Measurement Period" is not null

- Denominator
  - "Initial Population"

Denominator Exclusions

Hospice."Has Hospice"
  or exists "Prior Diagnosis of Dependence"

Numerator

exists "Dependence Treatment Intervention Initiated"
  or exists "Treatment Initiation With Medication Order"

- Numerator Exclusions
  - None
- Denominator Exceptions
  - None

Stratification 1

exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
    where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, 
    end of "Measurement Period" ) in Interval[13, 17]
)

Stratification 2

exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
    where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, 
    end of "Measurement Period" ) >= 18
)

Population Criteria 2

Initial Population

exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
  where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 13
    and "First Dependence Diagnosis During Measurement Period" is not null

- Denominator
  - "Initial Population"

Denominator Exclusions

Hospice."Has Hospice"
  or exists "Prior Diagnosis of Dependence"

Numerator

"Has Dependence Treatment Intervention Continued"
  or exists ( "Treatment with Single Medication Order During Measurement Period" ContinuedTreatment
      with "Dependence Treatment Intervention Initiated" InitiatedMedicationTreatment
        such that ContinuedTreatment.authorDatetime 34 days or less after start of InitiatedMedicationTreatment.relevantPeriod
  )
  or "Has Treatment Initiation With Medication and Continuation of Treatment with Encounters"
  or ( exists "Continuation of Treatment Event"
      and exists ( "Treatment with Single Medication Order During Measurement Period" ContinuedTreatment
          with ( "Treatment Initiation With Medication Order" ) InitiatedTreatment
            such that ContinuedTreatment.authorDatetime 34 days or less after start of InitiatedTreatment.relevantPeriod
      )
  )

- Numerator Exclusions
  - None
- Denominator Exceptions
  - None

Stratification 1

exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
    where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, 
    end of "Measurement Period" ) in Interval[13, 17]
)

Stratification 2

exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
    where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, 
    end of "Measurement Period" ) >= 18
)

Definitions

Continuation of Treatment Event

( ["Intervention, Performed": "Alcohol and Drug Dependence Treatment"]
  union ["Intervention, Performed": "Psych Visit - Psychotherapy"]
  union ["Encounter, Performed": "Telehealth Services"] ) ContinuedTreatment
  with ( "Treatment Initiation With Medication Order" ) TreatmentEvent
    such that ContinuedTreatment.relevantPeriod starts 34 days or less after start of TreatmentEvent.relevantPeriod

Denominator
- - "Initial Population"

Denominator Exclusions

Hospice."Has Hospice"
  or exists "Prior Diagnosis of Dependence"

Dependence Treatment Intervention Initiated

( ( ["Intervention, Performed": "Alcohol and Drug Dependence Treatment"]
    union ["Intervention, Performed": "Psych Visit - Psychotherapy"]
    union ["Encounter, Performed": "Telehealth Services"] ) TreatmentInitiatedWithIntervention
    with ( "First Dependence Diagnosis During Measurement Period" ) FirstDiagnosed
      such that TreatmentInitiatedWithIntervention.relevantPeriod starts 14 days or less after day of start of FirstDiagnosed.prevalencePeriod
)

First Dependence Diagnosis During Measurement Period

First(["Diagnosis": "Alcohol and Drug Dependence"] InitialDependenceDiagnosis
    with("Qualifying Encounters")ValidEncounter
      such that InitialDependenceDiagnosis.prevalencePeriod starts during ValidEncounter.relevantPeriod
        and InitialDependenceDiagnosis.prevalencePeriod starts 48 days or more before day of 
        end of "Measurement Period"
    sort by start of prevalencePeriod
)

Has Dependence Treatment Intervention Continued

Count((["Intervention, Performed": "Alcohol and Drug Dependence Treatment"]
    union ["Intervention, Performed": "Psych Visit - Psychotherapy"]
    union ["Encounter, Performed": "Telehealth Services"])ContinuedTreatment
    with("Dependence Treatment Intervention Initiated")InitiatedTreatment
      such that ContinuedTreatment.relevantPeriod starts 34 days or less after start of InitiatedTreatment.relevantPeriod
)>= 2

Has Treatment Initiation With Medication and Continuation of Treatment with Encounters

Count((["Intervention, Performed": "Alcohol and Drug Dependence Treatment"]
    union ["Intervention, Performed": "Psych Visit - Psychotherapy"]
    union ["Encounter, Performed": "Telehealth Services"])ContinuedTreatment
    with("Treatment Initiation With Medication Order")InitiatedTreatment
      such that ContinuedTreatment.relevantPeriod starts 34 days or less after start of InitiatedTreatment.relevantPeriod
)>= 2

Hospice.Has Hospice

exists ( ["Encounter, Performed": "Encounter Inpatient"] DischargeHospice
    where ( DischargeHospice.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
        or DischargeHospice.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
    )
      and DischargeHospice.relevantPeriod ends during "Measurement Period"
)
  or exists ( ["Intervention, Order": "Hospice care ambulatory"] HospiceOrder
      where HospiceOrder.authorDatetime during "Measurement Period"
  )
  or exists ( ["Intervention, Performed": "Hospice care ambulatory"] HospicePerformed
      where HospicePerformed.relevantPeriod overlaps "Measurement Period"
  )

Initial Population

exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
  where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 13
    and "First Dependence Diagnosis During Measurement Period" is not null

Numerator 1

exists "Dependence Treatment Intervention Initiated"
  or exists "Treatment Initiation With Medication Order"

Numerator 2

"Has Dependence Treatment Intervention Continued"
  or exists ( "Treatment with Single Medication Order During Measurement Period" ContinuedTreatment
      with "Dependence Treatment Intervention Initiated" InitiatedMedicationTreatment
        such that ContinuedTreatment.authorDatetime 34 days or less after start of InitiatedMedicationTreatment.relevantPeriod
  )
  or "Has Treatment Initiation With Medication and Continuation of Treatment with Encounters"
  or ( exists "Continuation of Treatment Event"
      and exists ( "Treatment with Single Medication Order During Measurement Period" ContinuedTreatment
          with ( "Treatment Initiation With Medication Order" ) InitiatedTreatment
            such that ContinuedTreatment.authorDatetime 34 days or less after start of InitiatedTreatment.relevantPeriod
      )
  )

Prior Diagnosis of Dependence

["Diagnosis": "Alcohol and Drug Dependence"] PriorDependenceDiagnosis
  with ( "First Dependence Diagnosis During Measurement Period" ) FirstDiagnosed
    such that PriorDependenceDiagnosis.prevalencePeriod starts 60 days or less before start of FirstDiagnosed.prevalencePeriod

Qualifying Encounters

( ["Encounter, Performed": "Office Visit"]
  union ["Encounter, Performed": "Emergency Department Visit"]
  union ["Encounter, Performed": "Detoxification Visit"]
  union ["Encounter, Performed": "Hospital Observation Care - Initial"]
  union ["Encounter, Performed": "Hospital Inpatient Visit - Initial"]
  union ["Encounter, Performed": "Discharge Services - Hospital Inpatient Same Day Discharge"]
  union ["Encounter, Performed": "Discharge Services - Hospital Inpatient"]
  union ["Encounter, Performed": "Telehealth Services"] ) ValidEncounters
  where ValidEncounters.relevantPeriod during "Measurement Period"

SDE Ethnicity

["Patient Characteristic Ethnicity": "Ethnicity"]

SDE Payer

["Patient Characteristic Payer": "Payer"]

SDE Race
- - ["Patient Characteristic Race": "Race"]

SDE Sex

["Patient Characteristic Sex": "ONC Administrative Sex"]

Stratification 1

exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
    where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, 
    end of "Measurement Period" ) in Interval[13, 17]
)

Stratification 2

exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
    where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, 
    end of "Measurement Period" ) >= 18
)

Treatment Initiation With Medication Order

( ( ["Medication, Order": "Opiate Antagonists"] ) TreatmentInitiatedWithMedication
    with ( "First Dependence Diagnosis During Measurement Period" ) FirstDiagnosed
      such that start of TreatmentInitiatedWithMedication.relevantPeriod 14 days or less on or after day of start of FirstDiagnosed.prevalencePeriod
)

Treatment with Single Medication Order During Measurement Period

["Medication, Order": "Opiate Antagonists"] MedicationOrderOpiate
  where MedicationOrderOpiate.authorDatetime during "Measurement Period"

Functions

Global.CalendarAgeInYearsAt(BirthDateTime DateTime, AsOf DateTime)
- - years between ToDate(BirthDateTime)and ToDate(AsOf)

Global.ToDate(Value DateTime)

DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)

Terminology

code "Birth date" ("LOINC Code (21112-8)")
code "Discharge to healthcare facility for hospice care (procedure)" ("SNOMEDCT Code (428371000124100)")
code "Discharge to home for hospice care (procedure)" ("SNOMEDCT Code (428361000124107)")
valueset "Alcohol and Drug Dependence" (2.16.840.1.113883.3.464.1003.106.12.1001)
valueset "Alcohol and Drug Dependence Treatment" (2.16.840.1.113883.3.464.1003.106.12.1005)
valueset "Detoxification Visit" (2.16.840.1.113883.3.464.1003.101.12.1059)
valueset "Discharge Services - Hospital Inpatient" (2.16.840.1.113883.3.464.1003.101.12.1007)
valueset "Discharge Services - Hospital Inpatient Same Day Discharge" (2.16.840.1.113883.3.464.1003.101.12.1006)
valueset "Emergency Department Visit" (2.16.840.1.113883.3.464.1003.101.12.1010)
valueset "Encounter Inpatient" (2.16.840.1.113883.3.666.5.307)
valueset "Ethnicity" (2.16.840.1.114222.4.11.837)
valueset "Hospice care ambulatory" (2.16.840.1.113762.1.4.1108.15)
valueset "Hospital Inpatient Visit - Initial" (2.16.840.1.113883.3.464.1003.101.12.1004)
valueset "Hospital Observation Care - Initial" (2.16.840.1.113883.3.464.1003.101.12.1002)
valueset "Office Visit" (2.16.840.1.113883.3.464.1003.101.12.1001)
valueset "ONC Administrative Sex" (2.16.840.1.113762.1.4.1)
valueset "Opiate Antagonists" (2.16.840.1.113883.3.464.1003.198.12.1132)
valueset "Payer" (2.16.840.1.114222.4.11.3591)
valueset "Psych Visit - Psychotherapy" (2.16.840.1.113883.3.526.3.1496)
valueset "Race" (2.16.840.1.114222.4.11.836)
valueset "Telehealth Services" (2.16.840.1.113883.3.464.1003.101.12.1031)

Data Criteria (QDM Data Elements)

"Diagnosis: Alcohol and Drug Dependence" using "Alcohol and Drug Dependence (2.16.840.1.113883.3.464.1003.106.12.1001)"
"Encounter, Performed: Detoxification Visit" using "Detoxification Visit (2.16.840.1.113883.3.464.1003.101.12.1059)"
"Encounter, Performed: Discharge Services - Hospital Inpatient" using "Discharge Services - Hospital Inpatient (2.16.840.1.113883.3.464.1003.101.12.1007)"
"Encounter, Performed: Discharge Services - Hospital Inpatient Same Day Discharge" using "Discharge Services - Hospital Inpatient Same Day Discharge (2.16.840.1.113883.3.464.1003.101.12.1006)"
"Encounter, Performed: Emergency Department Visit" using "Emergency Department Visit (2.16.840.1.113883.3.464.1003.101.12.1010)"
"Encounter, Performed: Encounter Inpatient" using "Encounter Inpatient (2.16.840.1.113883.3.666.5.307)"
"Encounter, Performed: Hospital Inpatient Visit - Initial" using "Hospital Inpatient Visit - Initial (2.16.840.1.113883.3.464.1003.101.12.1004)"
"Encounter, Performed: Hospital Observation Care - Initial" using "Hospital Observation Care - Initial (2.16.840.1.113883.3.464.1003.101.12.1002)"
"Encounter, Performed: Office Visit" using "Office Visit (2.16.840.1.113883.3.464.1003.101.12.1001)"
"Encounter, Performed: Telehealth Services" using "Telehealth Services (2.16.840.1.113883.3.464.1003.101.12.1031)"
"Intervention, Order: Hospice care ambulatory" using "Hospice care ambulatory (2.16.840.1.113762.1.4.1108.15)"
"Intervention, Performed: Alcohol and Drug Dependence Treatment" using "Alcohol and Drug Dependence Treatment (2.16.840.1.113883.3.464.1003.106.12.1005)"
"Intervention, Performed: Hospice care ambulatory" using "Hospice care ambulatory (2.16.840.1.113762.1.4.1108.15)"
"Intervention, Performed: Psych Visit - Psychotherapy" using "Psych Visit - Psychotherapy (2.16.840.1.113883.3.526.3.1496)"
"Medication, Order: Opiate Antagonists" using "Opiate Antagonists (2.16.840.1.113883.3.464.1003.198.12.1132)"
"Patient Characteristic Birthdate: Birth date" using "Birth date (LOINC Code 21112-8)"
"Patient Characteristic Ethnicity: Ethnicity" using "Ethnicity (2.16.840.1.114222.4.11.837)"
"Patient Characteristic Payer: Payer" using "Payer (2.16.840.1.114222.4.11.3591)"
"Patient Characteristic Race: Race" using "Race (2.16.840.1.114222.4.11.836)"
"Patient Characteristic Sex: ONC Administrative Sex" using "ONC Administrative Sex (2.16.840.1.113762.1.4.1)"

Supplemental Data Elements

SDE Ethnicity

["Patient Characteristic Ethnicity": "Ethnicity"]

SDE Payer

["Patient Characteristic Payer": "Payer"]

SDE Race
- - ["Patient Characteristic Race": "Race"]

SDE Sex

["Patient Characteristic Sex": "ONC Administrative Sex"]

Risk Adjustment Variables

None

Measure Set

None