Thank you for the feedback. The various measure developers, who may be impacted by this conversation, will discuss and review with the technical expert panel and other stakeholders, the appropriateness of adding Assessment, Performed data element as an option to allow for flexibility in capturing hospice or palliative care for a future annual update.

We appreciate the efforts to align the hospice data elements. The measures need to consider eligible clinicians that do not order or provide hospice or Palliative care. The data elements currently used may not be available within the providers systems depending upon where these actions occurred. Without these data elements the exclusion cannot be met. It is likely many eligible clinicians will not be the provider to order or provide hospice or Palliative care. Eligible Clinicians should be able to assess and document that their patients are currently receiving Hospice or Palliative care. Adding an Assessment, Performed data element to allow clinical documentation of a patient receiving this type of care to both definitions will reduce burden, improve communication of this important information and align these two similar definitions.