Brief Description of Measure: CMS56: Functional Status Assessment for Total Hip Replacement Percentage of patients 19 years of age and older who received an elective primary total hip arthroplasty (THA) and completed a functional status assessment within 90 days prior to the surgery and in the 300 - 425 days after the surgery Description of Issue: The current measure requirements for initial population, denominator, and numerator are as follows: "Patients 19 years of age and older who had a primary THA between November two years prior to the measurement period and October of the year prior to measurement period; and who had an outpatient encounter between November of the year prior to the measurement period and the end of the measurement period" and "Patients with patient-reported functional status assessment (FSA) results in the 90 days prior to or on the day of the primary THA procedure, and in the 300-425 days after the THA procedure". Currently, the qualifying encounter is required between November of the year prior to the measurement period and the end of the measurement period. Theoretically, a patient can have a primary THA and a follow-up FSA (300-425 days after the THA) that occur prior to the measurement period, but that patient must also have a qualifying encounter within the specified timeframe to be captured in the denominator. As the measure is currently specified, a patient who has a primary THA and a follow-up FSA on the earliest possible date, without a qualifying encounter within the specified timeframe, will not be included in the measure.

Proposed Solution: The proposed solution is to expand the qualifying encounter timeframe from "November of the year prior to the measurement period and the end of the measurement period" to "August of the year prior to the measurement period and the end of the measurement period" to capture those who had a THA procedure and a follow-up FSA as early as possible. Initial Population header before: [...]and who had an outpatient encounter between November of the year prior to the measurement period and the end of the measurement period Initial Population header after: [...]and who had an outpatient encounter between August of the year prior to the measurement period and the end of the measurement period Initial Population logic before: define "Qualifying Encounter": [...]     where ValidEncounters.relevantPeriod during day of Interval["November 1 Year Prior to the Measurement Period", end of "Measurement Period"]) define "November 1 Year Prior to the Measurement Period":   DateTime((year from start of "Measurement Period" - 1), 11, 1, 0, 0, 0, 0, 0) Initial Population logic after: define "Qualifying Encounter": [...]     where ValidEncounters.relevantPeriod during day of Interval["August 1 Year Prior to the Measurement Period", end of "Measurement Period"]) define "August 1 Year Prior to the Measurement Period":   DateTime((year from start of "Measurement Period" - 1), 8, 1, 0, 0, 0, 0, 0) Rationale for Change: This revision will align with the measure intent to capture those who had a THA procedure and a follow-up FSA at the earliest possible dates.