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CMS1028v2 - Risk Adjustment Implementation

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      ​​Thank you for your questions.
      The hospital-level measure score is equivalent to the hospital specific RSOCR multiplied by 10,000.

      National average (y bar) and risk variable parameters (beta coefficients) will not be available until after all data are submitted for 2023 deliveries in Spring 2024. We are working with CMS to determine where yearly model parameter information will be published.

      If CMS decides to make the coding syntax public, it would be available in late Summer 2024 at the earliest.

      An individual state can perform risk-adjusted analyses to calculate measure scores for hospitals in the state, but the measure scores will differ from the national measure scores (to be reported for all hospitals starting with 2024 deliveries) if the starting population is different and hierarchical models are re-estimated.
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      ​​Thank you for your questions. The hospital-level measure score is equivalent to the hospital specific RSOCR multiplied by 10,000. National average (y bar) and risk variable parameters (beta coefficients) will not be available until after all data are submitted for 2023 deliveries in Spring 2024. We are working with CMS to determine where yearly model parameter information will be published. If CMS decides to make the coding syntax public, it would be available in late Summer 2024 at the earliest. An individual state can perform risk-adjusted analyses to calculate measure scores for hospitals in the state, but the measure scores will differ from the national measure scores (to be reported for all hospitals starting with 2024 deliveries) if the starting population is different and hierarchical models are re-estimated.
    • CMS1028v2
    • The details of risk adjustment calculations would be valuable for implementing this measure into a state Medicaid incentive program.

      To whom it may concern, 

      Per contents in 2.8 Calculation of Measure Score from the Methodology Report, please consider the inquiries below:

      Inquiry #1: As defined in the writing, "Hospital-level measure scores were calculated as a standardized proportion of the number of delivery hospitalizations for patients who experience a severe obstetric complication, as defined by the numerator, by the total number of delivery hospitalizations in the denominator during the measurement period.", while "The hospital specific RSOCRs were calculated as the ratio of a hospital’s “predicted” number of delivery hospitalizations with a severe obstetric complication to “expected” number of delivery hospitalizations with a severe obstetric complication, multiplied by the overall observed rate of delivery hospitalizations with a severe obstetric complication.", wondering whether "Hospital-level measure scores" and "The hospital specific RSOCRs" are equivalent terms that both represent hospital level results that might be used for hospital evaluations and comparisons?

      Inquiry #2: Would it be possible for the measure development team to share the syntax (or equivalent written instructions) on how the risk adjustment calculations are conducted? Specifically, we need to answer questions below:

      a. Would you provide a set of official parameters for risk variables and hospital average/specific intercepts to implement measure calculations, or it'd be for us to implement the hierarchical model using GLIMMIX/LOGISTIC (or comparable) procedures on our local data to come up with parameters for calculations?

      b. As you define Risk-Standardized Obstetric Complications Rate as RSOCR = SRR x y bar, where y bar is the national observed severe obstetric complications rate, would you provide the value for y bar (or point us to where we can find this value), or we'd calculate the value as the local overall observed severe obstetric complications rate during our implementation?

        1. SevereObstetricComplications eCQM_Methodology Report - Dec 2022.pdf
          1.65 MB

            JLeflore Mathematica EH eCQM Team
            wlv WEN LV
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