Add hospice exclusion to all NCQA HEDIS measures. In 2016, NCQA added a requirement to exclude patients in hospice from the eligible population of almost all HEDIS health plan measures. The rationale to exclude those on hospice is that the quality measures focus on screenings, procedures, outcomes, etc., that are not appropriate or a priority for those who are at end of life (ie on hospice). We used four options to model the exclusion, all of which align with the techniques used to model similar exclusions for the EH measures. Two of them use the Intervention category, with the intervention being either ordered or performed. We've also included two options to identify hospice as a discharge status for an inpatient encounter. This option would be available to those who have access to an integrated healthcare system EHR.   To align with the parent HEDIS plan measures, we recommend adding logic to the denominator exclusions for every Meaningful Use-2 HEDIS measure: Denominator Exclusions = ◦OR: "Encounter, Performed: Encounter Inpatient (discharge status: Discharged to Home for Hospice Care)” ends during “Measurement Period” ◦OR: “Encounter, Performed: Encounter Inpatient (discharge status: Discharged to Health Care Facility for Hospice Care)” ends during “Measurement Period” ◦OR: Union Of: ◾ "Intervention, Order: Hospice care ambulatory" ◾"Intervention, performed: Hospice care ambulatory" ◾overlaps "Measurement Period" ​ Additionally, we propose to rename and repurpose the existing ‘Hospice care all settings’ value set to ‘Hospice care ambulatory’ to make it a distinctly ambulatory focus. We will limit the value set to the following two SNOMED codes: 385763009 Hospice care (regime/therapy) 385765002 Hospice care management (procedure)

Measure Description: NA. This change will be added to all measures. Issue Description: In 2016, we added a requirement to exclude patients in hospice from the eligible population of almost all HEDIS health plan measures. Therefore, during the 2017 Annual Update, we will add this as a denominator exclusion to all MU2 measures that are tied to a HEDIS health plan measure. Patients should not be included in the Initial Population if they are in hospice care at any time during the measurement period. Change Description:      The following logic will be added to the denominator exclusions for every Meaningful Use-2 HEDIS measure:      OR: “Intervention, Performed: Hospice Care All Settings” overlaps “Measurement Period" https://ecqi.healthit.gov/ep/ecqms-2017-performance-period/childhood-immunization-status

​Add hospice exclusion to all NCQA HEDIS measures. In 2016, NCQA added a requirement to exclude patients in hospice from the eligible population of almost all HEDIS health plan measures. The rationale to exclude those on hospice is that the quality measures focus on screenings, procedures, outcomes, etc., that are not appropriate or a priority for those who are at end of life (ie on hospice). We used four options to model the exclusion, all of which align with the techniques used to model similar exclusions for the EH measures. Two of them use the Intervention category, with the intervention being either ordered or performed. We've also included two options to identify hospice as a discharge status for an inpatient encounter. This option would be available to those who have access to an integrated healthcare system EHR.   To align with the parent HEDIS plan measures, we recommend adding logic to the denominator exclusions for every Meaningful Use-2 HEDIS measure: Denominator Exclusions =        OR: "Encounter, Performed: Encounter Inpatient" (discharge status: Discharged to Home for Hospice Care) ends during "Measurement Period"        OR: "Encounter, Performed: Encounter Inpatient" (discharge status: Discharged to Health Care Facility for Hospice Care) ends during "Measurement Period"        OR: "Intervention, Order: Hospice care ambulatory" satisfies all:               starts before end of "Measurement Period"               overlaps "Measurement Period"        OR: "Intervention, Performed: Hospice care ambulatory" satisfies all:               starts before end of "Measurement Period"               overlaps "Measurement Period" Additionally, we propose to rename and repurpose the existing ‘Hospice care all settings’ value set to ‘Hospice care ambulatory’ to make it a distinctly ambulatory focus. We will limit the value set to the following two SNOMED codes: 385763009 Hospice care (regime/therapy) 385765002 Hospice care management (procedure)