eMeasure Title

HIV/AIDS: RNA Control for Patients with HIV

eMeasure Identifier (Measure Authoring Tool) 77 eMeasure Version number 5.1.000
NQF Number Not Applicable GUID e0a07809-7b74-473f-bcc4-1891be506aaa
Measurement Period January 1, 20XX through December 31, 20XX
Measure Steward Centers for Medicare & Medicaid Services (CMS)
Measure Developer National Committee for Quality Assurance
Endorsed By None
Description
Percentage of patients aged 13 years and older with a diagnosis of HIV/AIDS, with at least two visits during the measurement year, with at least 90 days between each visit, whose most recent HIV RNA level is <200 copies/mL
Copyright
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 CPT or other codes contained in the specifications. 

CPT(R) contained in the Measure specifications is copyright 2004-2015 American Medical Association. LOINC(R) copyright 2004-2015 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2015 International Health Terminology Standards Development Organisation. ICD-10 copyright 2015 World Health Organization. All Rights Reserved.
Disclaimer
These performance Measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.

THE MEASURES 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 Outcome
Stratification
None
Risk Adjustment
None
Rate Aggregation
None
Rationale
According to the Panel on Antiretroviral Guidelines for Adults and Adolescents, the primary goals for the treatment of patients with HIV are to: 
"1) reduce HIV-associated morbidity and prolong the duration and quality of survival; 2) restore and preserve immunologic function; 3) maximally and durably suppress plasma HIV viral load; and 4) prevent HIV transmission." (2015)
Clinical Recommendation Statement
"Optimal viral suppression is defined generally as a viral load persistently below the level of detection (HIV RNA 200 copies/mL - a threshold that eliminates most cases of apparent viremia caused by viral load blips or assay variability)." (Panel on Antiretroviral Guidelines for Adults and Adolescents, 2015)
Improvement Notation
A higher score indicates better quality
Reference
Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. Available at http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf. Accessed December 18, 2015.
    
Definition
None
Guidance
None
Transmission Format
TBD
Initial Population
All patients aged 13 years and older with a diagnosis of HIV/AIDS with at least two visits during the measurement year, with at least 90 days between each visit
Denominator
Equals Initial Population
Denominator Exclusions
None
Numerator
Patients whose most recent HIV RNA level is <200 copies/mL during the measurement period
Numerator Exclusions
Not Applicable
Denominator Exceptions
None
Supplemental Data Elements
For every patient evaluated by this measure also identify payer, race, ethnicity and sex

Table of Contents


Population Criteria

Data Criteria (QDM Variables)

Data Criteria (QDM Data Elements)

Supplemental Data Elements

Risk Adjustment Variables


Measure Set
Not Applicable