Brief Description of Measure:

CMS74: Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists

Percentage of children, 6 months - 20 years of age, who received a fluoride varnish application during the measurement period

Description of Issue:

The current header narrative for stratifications does not align with the logic, which causes confusion for implementers.

Proposed Solution:

We propose updating the Stratification field in the header and logic:

CURRENT STRATIFICATION HEADER LANGUAGE:
Population 1: age 6 months - 5 years
Population 2: age 6- 2
Population 3: age 13-20

PROPOSED STRATIFICATION HEADER LANGUAGE:
Population 1: Patients age 6 months - 5 years at the start of the Measurement Period
Population 2: Patients age 6-12 years at the start of the Measurement Period
Population 3: Patients age 13-20 years at the start of the Measurement Period

CURRENT LOGIC:
Stratification 1
exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
where Global."CalendarAgeInMonthsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 6
and Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) <= 4)

Stratification 2
exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) in Interval[5, 11]

Stratification 3
exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) in Interval[12, 20 )

UPDATED LOGIC:
Stratification 1
exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
where Global."CalendarAgeInMonthsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 6
and Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) <= 5)

Stratification 2
exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) in Interval[6, 12]

Stratification 3
exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) in Interval[13, 20 ]

Rationale for Change:
We propose adding more details in the 'Stratification' field of the header to provide clarity, as well as updating the logic to align with the narrative and measure intent. We believe these updates will reduce confusion for implementers.