Brief Description of Measure:

​CMS137: Initiation and Engagement of Alcohol and Other Drug Dependence Treatment:
Percentage of patients 13 years of age and older with a new episode of alcohol or other drug abuse or (AOD) dependence who received the following. Two rates are reported.
a. Percentage of patients who initiated treatment including either an intervention or medication for the treatment of AOD abuse or dependence within 14 days of the diagnosis
b. Percentage of patients who engaged in ongoing treatment including two additional interventions or a medication for the treatment of AOD abuse or dependence within 34 days of the initiation visit. For patients who initiated treatment with a medication, at least one of the two engagement events must be a treatment intervention.

Description of Issue:

​The measure currently includes two stratum based on age - 13-17 years and >=18 years. NCQA proposes to update the age stratifications to three stratifications, in addition to a total rate: age 13-17 years (adolescents), age 18-64 (adults), and age 65+ (older adults). This proposed change will increase the utility and  actionability of the data collected for this measure, as well as help highlight gaps in care. 
 
These updated age stratifications also better align the measure with reporting  stratifications used in other NCQA substance use disorder treatment measures. Stakeholders on NCQA's advisory panels support the proposed changes to the age stratifications.

Proposed Solution:

//Header: Stratification
//Before
Report a total score, and each of the following strata:
Stratum 1: Patients age 13-17 at the start of the Measurement Period
Stratum 2: Patients age >=18 at the start of the Measurement Period
 
//After
Report a total score, and each of the following strata:
Stratum 1: Patients age 13-17 at the start of the Measurement Period
Stratum 2: Patients age 18-64 at the start of the Measurement Period
Stratum 3: Patients age 65 and older at the start of the Measurement Period

//Logic
//Before
define "Stratification 2":
  exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
      where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 18
  )

//After
define "Stratification 2":
  AgeInYearsAt(date from start of "Measurement Period")in Interval[18, 64]

define "Stratification 3":
  AgeInYearsAt(date from start of "Measurement Period")>= 65

Rationale for Change:

The updated age stratifications align with those used in other NCQA substance use disorder treatment measures and will increase the utility and actionability of the data collected for the measure, as well as help highlight gaps in care.