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  2. CQM-6061

CMS871-HH-02-Overall Performance Rate Calculation: Do we include the "Eligible Days" for encounters that do not have Hyperglycemic events in the overall performance rate calculation?

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    • Icon: EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals
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      ​Thank you for your inquiry regarding CMS871v2. To determine the measure performance rate, the total number of hyperglycemic event days during the inpatient hospitalizations (which is the Measure Observation 2 associated with the Numerator) is divided by the total number of eligible hospital days of the inpatient hospitalizations (which is the Measure Observation 1, associated with the Denominator).

      The performance rate based on your scenario of two encounters results in Outcome 1: 40%. Eligible hospital days (denominator) are counted across all encounters even if no hyperglycemic events (numerator) occur during the encounters.
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      ​Thank you for your inquiry regarding CMS871v2. To determine the measure performance rate, the total number of hyperglycemic event days during the inpatient hospitalizations (which is the Measure Observation 2 associated with the Numerator) is divided by the total number of eligible hospital days of the inpatient hospitalizations (which is the Measure Observation 1, associated with the Denominator). The performance rate based on your scenario of two encounters results in Outcome 1: 40%. Eligible hospital days (denominator) are counted across all encounters even if no hyperglycemic events (numerator) occur during the encounters.
    • CMS0871v2
    • Understanding this will help ensure that we are calculating the overall performance rate accurately.

      I will ask my question with the use of the example below.

      Says there are 2 patients each with 1 encounter in the measurement period.

      Patient1 Encounter ID: EOC1
      Hyperglycemic Event Days (Numerator) = 10
      Eligible Event Days (Denominator) = 20
      Performance Rate for this encounter = 10/20 = 50%

      Patient2 Encounter ID: EOC2
      Hyperglycemic Event Days (Numerator) = 0 (Basically this patient did not have any hyperglycemic events)
      Eligible Event Days (Denominator)= 5  (Do we include these Eligible event days in the overall
      Rate for this encounter = Not Applicable (since there are no hyperglycemic event days). The patient will not be in the Numerator population.

      Overall Performance Rate for all patients (2 in this example) combined

      My question is - which of the following 2 outcomes provided below are correct?

      Outcome 1: 
      Overall Performance Rate: 10/25? = 40%
      Here, I have included the 5 Eligible Days from Patient 2 in the Denominator. 

      OR

      Outcome 2: 
      Overall Performance Rate: 10/20? = 50%
      Here, I have NOT included the 5 Eligible Days from Patient 2 in the Denominator. 

            JLeflore Joelencia Leflore
            mparekhji Manish Parekhji
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