CMS126v4 stratification question

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Minor
    • Component/s: Measure
    • None
    • Elissa Chandler
    • 267-725-5354
    • NextGen
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      The stratums do not overlap as the upper age range is always less than and the lower age range is greater than or equal to. For example, an 11 year old at the start of the measurement period would not be included in stratum 1 because they are not less than 11. The patient who is 11 years old at the start of the measurement period would be included in stratum 2 because they are greater than or equal to 11.

      Additionally, because age is calculated based on 1/1 of the measurement period, the ranges in the logic match the ranges in the description. For example, if you are 10 years old on the first day of the measurement period, you will turn 11 sometime during the measurement period, so you should be included in the first stratum. If you are 11 years old on the first day of the measurement period, you will turn 12 during the measurement period and should be included in the second stratum.
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      The stratums do not overlap as the upper age range is always less than and the lower age range is greater than or equal to. For example, an 11 year old at the start of the measurement period would not be included in stratum 1 because they are not less than 11. The patient who is 11 years old at the start of the measurement period would be included in stratum 2 because they are greater than or equal to 11. Additionally, because age is calculated based on 1/1 of the measurement period, the ranges in the logic match the ranges in the description. For example, if you are 10 years old on the first day of the measurement period, you will turn 11 sometime during the measurement period, so you should be included in the first stratum. If you are 11 years old on the first day of the measurement period, you will turn 12 during the measurement period and should be included in the second stratum.
    • CMS126v4/NQF0036
    • high impacts eCQM development

      QUESTION: CMS126v4

      For CMS126v4, there is a discrepancy between the Stratification description and the stratification logic. And also the stratification logic would cause certain patients to be reported in two different strata.

      In the description, we are looking for:
      Stratum 1: Patients age 5-11
      Stratum 2: Patients age 12-18
      Stratum 3: Patients age 19-50
      Stratum 4: Patients age 51-64

      While the logic is stating:
      ◦Stratification 1 =
      ■ AND: Age >= 5 year(s) at: "Measurement Period"
      ■ AND: Age < 11 year(s) at: "Measurement Period"

      ◦Stratification 2 =
      ■ AND: Age >= 11 year(s) at: "Measurement Period"
      ■ AND: Age < 18 year(s) at: "Measurement Period"

      ◦Stratification 3 =
      ■ AND: Age >= 18 year(s) at: "Measurement Period"
      ■ AND: Age < 50 year(s) at: "Measurement Period"

      ◦Stratification 4 =
      ■ AND: Age >= 50 year(s) at: "Measurement Period"
      ■ AND: Age < 64 year(s) at: "Measurement Period"

      According to the logic, Stratum 1 and Stratum 2 would cover 11 years of age and there would be situations where a patient may meet both strata.
      Stratum 2 and Stratum 3 would cover 18 years of age and there would be situations where a patient may meet both strata.
      Stratum 3 and Stratum 4 would cover 50 years of age and there would be situations where a patient may meet both strata.

      QUESTIONS:
      1. Do we use the logic or the description to build this measure as stratum
      2, 3, 4 would have ages out of the descriptions’ range if we use the logic?

      2. If we do use the logic to develop, can you please clarify if a patient is allowed to meet two strata?

            Assignee:
            Mathematica EC eCQM Team (Inactive)
            Reporter:
            Elissa Chandler (Inactive)
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