Hybrid Measure Hospice

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    • Type: Value Sets
    • Resolution: Unresolved
    • Priority: Moderate
    • None
    • Encounters for Hospice are being captured.
    • Kim Crady
    • 9043213735
    • Baptist Health

      Hello JIRA,

      Hospice / Palliative Care.

      Patients Who are admitted to hospice in our acute care hospital usually do not get Labs / Vital Signs. This places them in the denominator.

      Most of these patients have two separate encounters – one for the initial encounter, and one for the hospice encounter.  In the instances impacted – these patients do not get transferred to another floor or bed. Only their billing is changed.

      The Specs do not address this. This is being counted as a readmission.

      If the patient expires in the hospital - it is captured in the mortality.

       

      The specs:

      Inpatient Encounters

      from

        ["Encounter, Performed": "Encounter Inpatient"] InpatientEncounter,

       ["Patient Characteristic Payer": "Medicare payer"] Payer,

        ["Patient Characteristic Birthdate": "Birth date"] BirthDate

        where Global."HospitalizationWithObservationLengthofStay" ( InpatientEncounter ) < 365

         and InpatientEncounter.relevantPeriod ends during day of "Measurement Period"

         and Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of InpatientEncounter.relevantPeriod ) >= 65

       return InpatientEncounter

       

      There are no exclusion or exceptions in the specs.

       

      Example patient: (readmission and Mortality)

      (For the second encounter)

      Final Principle Dx is “Encounter for Palliative care”.

      With their Primary insurance as:

                    • HOSPICE OF NORTHEAST FLORIDA/ *********** HOSPICE OF NORTHEAST FLORIDA

      And a secondary insurance of Medicare.

       

      This impacts a number of patients.

      Will this be considered in future updates?

      Thanks,

      Kim

            Assignee:
            Michael Cocchiola (Inactive)
            Reporter:
            kim crady
            Votes:
            1 Vote for this issue
            Watchers:
            8 Start watching this issue

              Created:
              Updated: