CMS 69: a patient could qualify for both populations

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    • Type: Annual Update
    • Resolution: Answered
    • Priority: Minor
    • Component/s: Measure
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      As this may be true, there is no harm in counting one patient twice during the measurement year if they in fact do fall into both patient populations. Because there are different BMI values that would prompt a follow-up, a certain BMI value may be more concerning after the patient turned 65. So a patient that has two encounters during the measurement period, one when they are 64 and another as they turn 65, it would be important to perform necessary follow-up based on age and BMI values assessed. The IPP does not limit to being counted only once during the measurement period, but does specify “with at least one eligible encounter during the measurement period”.
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      As this may be true, there is no harm in counting one patient twice during the measurement year if they in fact do fall into both patient populations. Because there are different BMI values that would prompt a follow-up, a certain BMI value may be more concerning after the patient turned 65. So a patient that has two encounters during the measurement period, one when they are 64 and another as they turn 65, it would be important to perform necessary follow-up based on age and BMI values assessed. The IPP does not limit to being counted only once during the measurement period, but does specify “with at least one eligible encounter during the measurement period”.

      With the annual update in 2014, this measure now calculates the patient's age with respect to particular encounters, rather than the measurement period. This means that patients who turn 65 during the measurement period could qualify for both populations, if they have an encounter while they are still age 64 and another encounter after they turn 65. Furthermore, it seems possible that a patient could be in the numerator in one population, but only in the denominator in another population. Is this intentional?

            Assignee:
            Mathematica EC eCQM Team (Inactive)
            Reporter:
            Daphne Brinkerhoff
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