Our hospital voluntarily submitted the HWR CCDE  hybrid measure.  I have opened a ticket with Qualitynet about the missing report.  How does CMS calculate the percentages for the encounters with linking variables, vital signs and laboratory tests?  Is it an all or none approach? If one lab value is missing from an encounter, is that patient excluded from the numerator?  If one vital sign is missing from an encounter, is that patient excluded from the numerator?