Brief Description of Measure:

Multiple EC eCQMs

Description of Issue:

​There is an opportunity to improve the readability of the Denominator Exclusions logic by incorporating the age requirement for the long term care exclusion criteria into the library definition instead of specifying it in the individual measure definitions.
 
This issue is specific to incorporating the age requirement specified in "Denominator Exclusions" into the long term care exclusion library definition. Please note that proposed changes for the long term care exclusion content or age requirement are documented in other issues.

Proposed Solution:

CURRENT LOGIC:
//Exclusion definition from the AdvancedIllnessandFrailtyExclusionECQM library
FrailtyLTI."Has Long Term Care Periods Longer Than 90 Consecutive Days":
"Max Long Term Care Period Length" > 90

//CMS125, 130
define "Denominator Exclusions":
... or ( exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
       where ( Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 65 )
         and FrailtyLTI."Has Long Term Care Periods Longer Than 90 Consecutive Days" )

//CMS165
define "Denominator Exclusions":
or ( exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
        where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 65  )
      and ( FrailtyLTI."Has Long Term Care Periods Longer Than 90 Consecutive Days" ) )

//CMS122, 131, 134
define "Denominator Exclusions":
... or ( exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
      where ( Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 65 )
        and FrailtyLTI."Has Long Term Care Periods Longer Than 90 Consecutive Days"
        or ...  )

PROPOSED LOGIC:
//Exclusion definition from the AdvancedIllnessandFrailtyExclusionECQM library
FrailtyLTI."Age 66 and Older Living Long Term in a Nursing Home":
( AgeInYearsAt(date from
    end of "Measurement Period"
  )>= 66)
  and ( ( Last(["Assessment, Performed": "Housing status"] HousingStatus
        where Global."NormalizeInterval"(HousingStatus.relevantDatetime, HousingStatus.relevantPeriod)ends on or before
        end of "Measurement Period"
        sort by
        end of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)asc
    )) LastHousingStatus
      where LastHousingStatus.result ~ "Lives in a nursing home (finding)"
  ) is not null

//CMS125, 130, 165, 122, 131, 134, 138
define "Denominator Exclusions":
... or FrailtyLTI."Age 66 and Older Living Long Term in a Nursing Home"

Rationale for Change:

The proposed modification should improve the readability and clarity of each measure's "Denominator Exclusions" logic.