Brief Description of Measure:

​CMS69: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan:
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or within the previous twelve months AND who had a follow-up plan documented if most recent BMI was outside of normal parameters

Description of Issue:

The measure developer proposes refining the measure numerator statement and logic to align with measure intent, evidence and stakeholder feedback.

The current numerator allows the documentation of the BMI to occur during the encounter or the 12 months preceding the encounter. However, based upon the recommendations from the sources previously noted, the measure developer is proposing to modify the timing for the documentation of the BMI allow a 6 month look back from the date of the encounter, but still tie the BMI to being documented during the measurement period.

Proposed Solution:

​Current Numerator:
Patients with a documented BMI during the encounter or during the previous twelve months, AND when the BMI is outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter

Proposed Numerator:
Patients with a documented BMI during the measurement period, AND when the BMI is outside of normal parameters, a follow-up plan is documented during the encounter at the time of the most recent BMI or during the six months before the most recent BMI

Current logic:
Most Recent Documented BMI
Last(["Physical Exam, Performed": "Body mass index (BMI) [Ratio]"] BMI
    with "Qualifying Encounter during Measurement Period" QualifyingEncounter
      such that Global."NormalizeInterval"(BMI.relevantDatetime, BMI.relevantPeriod)ends 12 months or less on or before day of
      end of QualifyingEncounter.relevantPeriod
        and BMI.result >= 0 'kg/m2'
    sort by start of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)
)

Proposed logic:
Most Recent Documented BMI
Last(["Physical Exam, Performed": "Body mass index (BMI) [Ratio]"] BMI
    with "Qualifying Encounter during Measurement Period" QualifyingEncounter
      such that Global."NormalizeInterval"(BMI.relevantDatetime, BMI.relevantPeriod) same as day of
      end of QualifyingEncounter.relevantPeriod
or (Global."NormalizeInterval"(BMI.relevantDatetime, BMI.relevantPeriod) starts before day of QualifyingEncounter.relevantPeriod
and Global."NormalizeInterval"(BMI.relevantDatetime, BMI.relevantPeriod) during "Measurement Period")
        and BMI.result >= 0 'kg/m2'
    sort by start of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)
)

 Rationale for Change:

​The intent of the change is to have the clinical quality actions related in time and to the encounter. The BMI screening may take place on the day of the encounter or prior to the encounter and during the measurement period.