CMS to Test Claims-Based Measures in September

The Centers for Medicare and Medicaid Services (CMS) is conducting a national test for four new claims-based measures over the course of the next month. The measures include:

  • Hospital-level 30-day All-Cause Mortality Following Isolated Coronary Artery Bypass Graft Surgery (CABG mortality)
  • Hospital-level 30-day All-Cause Readmission Following Isolated CABG (CABG readmission)
  • Hospital-Level, Risk-Standardized Payment Associated with a 30-Day Episode of Care for Heart Failure (heart failure payment)
  • Hospital-Level, Risk-Standardized Payment Associated with a 30-Day Episode of Care for Pneumonia (pneumonia payment)

The test of the CABG mortality and readmission measures will take place Sept. 2 to Oct. 1, 2014 . A Hospital-Specific Report (HSR) for the measures will be available to hospitals and Quality Improvement Organizations (QIOs) on QualityNet Secure Portal by Sept. 2, 2014.

CMS will conduct a test of the heart failure and pneumonia payment measures from Sept. 8 to Oct. 7, 2014. An HSR for the measures will be available to hospitals and QIOs on QualityNet Secure Portal by Sept. 8, 2014.  

The HSRs contain discharge-level data, hospital-specific results, and state and national results for the measures. CMS encourages hospitals to review their HSR thoroughly. Detailed information about each measure is available on the QualityNet website.

CMS will hold two national provider calls to present the measures’ methodology and address questions related to these measures on Sept. 9 from 3-4:30 p.m. ET for the CABG measures and Sept. 16 from 3-4:30 p.m. ET for the payment measures. For more information about the national provider call, and to register to attend, visit the National Provider Calls page on QualityNet.

Questions about the CABG measures and the test can be submitted to cabg@yale.edu. Questions about the heart failure and pneumonia payment measures and the test can be submitted to cmsepisodepaymentmeasures@yale.edu.

Clinical Topics: Cardiac Surgery, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Cardiac Surgery and Heart Failure, Acute Heart Failure

Keywords: Quality Improvement, Pneumonia, Hospital Mortality, Heart Failure, Centers for Medicare and Medicaid Services (U.S.), Episode of Care, Coronary Artery Bypass


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