Brief Description of Measure:

CMS136: Follow-Up Care for Children Prescribed ADHD Medication (ADD):
Percentage of children 6-12 years of age and newly dispensed a medication for attention-deficit/hyperactivity disorder (ADHD) who had appropriate follow-up care. Two rates are reported.
a. Percentage of children who had one follow-up visit with a practitioner with prescribing authority during the 30-Day Initiation Phase.
b. Percentage of children who remained on ADHD medication for at least 210 days and who, in addition to the visit in the Initiation Phase, had at least two additional follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase ended.

Description of Issue:

The measure should assess patients 6-12 years of age relative to the Intake Period, because that is when patients could start taking ADHD medications. The current specification assesses patients 6-12 years during the measurement period, which does not align with the intent.

As such, the measure developer plans to update the age criteria from "6-11 at start of the measurement period" to "6 or older at start of the Intake Period and 12 or younger at end of the Intake Period".

Proposed Solution:

​Before

//Header

Initial Population 1:
Children 6-12 years of age who were dispensed an ADHD medication during the Intake Period and who had a visit during the measurement period.

Initial Population 2:
Children 6-12 years of age who were dispensed an ADHD medication during the Intake Period and who remained on the medication for at least 210 days out of the 300 days following the IPSD, and who had a visit during the measurement period.

//Logic

define "Initial Population 1":
exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
  where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) in Interval[6, 12 )...

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

After

//Header

Initial Population 1:
Children 6-12 years of age as of the Intake Period who were dispensed an ADHD medication during the Intake Period and who had a visit during the measurement period.

Initial Population 2:
Children 6-12 years of age as of the Intake Period who were dispensed an ADHD medication during the Intake Period and who remained on the medication for at least 210 days out of the 300 days following the IPSD, and who had a visit during the measurement period.

//Logic

define "Initial Population 1":
exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
  where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Intake Period" ) >= 6
    and Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime,
    end of "Intake Period" ) <= 12...

define "Initial Population 2":
exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
  where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Intake Period" ) >= 6
    and Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime,
    end of  "Intake Period" ) <= 12...

Rationale for Change:

The goal of this change is to bring the measure's technical age requirements into alignment with the measure intent.