Brief Description of Measure:

​CMS156: Use of High-Risk Medications in Older Adults:
Percentage of patients 65 years of age and older who were ordered at least two of the same high-risk medications.

Description of Issue:

​NCQA recommends aligning the age requirement of CMS156 with HEDIS MY2022 Use of High-Risk Medications in Older Adults (DAE), from which CMS156 is derived. Aligning the age requirement across measure variations reduces reporting burden on implementers.
 
The HEDIS MY2022 Use of High-Risk Medications in Older Adults (DAE) measure has an eligible population inclusive of individuals age 67 years and older as of  Dec. 31 of the measurement year. CMS156 has an initial population inclusive of patients age 65 years and older as of Jan. 1 of the measurement year.

Proposed Solution:

//Before
//Header: Description
Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class. Three rates are reported.
1. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class.
2. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class, except for appropriate diagnoses.
3. Total rate (the sum of the two numerators divided by the denominator, deduplicating for patients in both numerators).
 
//Header: Initial Population
Patients 65 years and older who had a visit during the measurement period
 
//Logic
define "Initial Population":
exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
  where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 65...
 
//After
//Header: Description
Percentage of patients 67 years of age and older who were ordered at least two high-risk medications from the same drug class. Three rates are reported.
1. Percentage of patients 67 years of age and older who were ordered at least two high-risk medications from the same drug class.
2. Percentage of patients 67 years of age and older who were ordered at least two high-risk medications from the same drug class, except for appropriate diagnoses.
3. Total rate (the sum of the two numerators divided by the denominator, deduplicating for patients in both numerators).
 
//Header: Initial Population
Patients 67 years and older at the end of the measurement period who had a visit during the measurement period
 
//Logic
define "Initial Population":
  AgeInYearsAt(date from
    end of "Measurement Period"
  )>= 67...

Rationale for Change:

​The goal of this change is to align the age requirement across measure versions and to reduce reporting burdens on implementers.