Brief Description of Measure: CMS50: Closing the Referral Loop: Receipt of Specialist Report Percentage of patients with referrals, regardless of age, for which the referring clinician receives a report from the clinician to whom the patient was referred Description of Issue: The measure steward proposes harmonizing the timing level of specificity to align with the level used in other measures by replacing DateTime with Date in the logic.

Proposed Solution: Using Date, instead of DateTime, aligns with how the logic is captured in other measures (e.g., Influenza). BEFORE First Referral during First 10 Months of Measurement Period First(((["Intervention, Performed": "Referral"] ReferralPerform       where Global."NormalizeInterval"(ReferralPerform.relevantDatetime, ReferralPerform.relevantPeriod)ends during day of Interval[start of "Measurement Period", DateTime(year from start of "Measurement Period", 10, 31)]       return {         identification: ReferralPerform.id,         dateIntervention:         end of Global."NormalizeInterval"(ReferralPerform.relevantDatetime, ReferralPerform.relevantPeriod)       }   )     union(["Intervention, Order": "Referral"] ReferralOrder         where ReferralOrder.authorDatetime during day of Interval[start of "Measurement Period", DateTime(year from start of "Measurement Period", 10, 31)]         return {           identification: ReferralOrder.id,           dateIntervention: ReferralOrder.authorDatetime         }     ))ReferralInterventions     sort by dateIntervention ascending )   AFTER First Referral during First 10 Months of Measurement Period First(((["Intervention, Performed": "Referral"] ReferralPerform       where Global."NormalizeInterval"(ReferralPerform.relevantDatetime, ReferralPerform.relevantPeriod)ends during day of Interval[start of "Measurement Period", Date(year from start of "Measurement Period", 10, 31)]       return {         identification: ReferralPerform.id,         dateIntervention:         end of Global."NormalizeInterval"(ReferralPerform.relevantDatetime, ReferralPerform.relevantPeriod)       }   )     union(["Intervention, Order": "Referral"] ReferralOrder         where ReferralOrder.authorDatetime during day of Interval[start of "Measurement Period", Date(year from start of "Measurement Period", 10, 31)]         return {           identification: ReferralOrder.id,           dateIntervention: ReferralOrder.authorDatetime         }     ))ReferralInterventions     sort by dateIntervention ascending ) Rationale for Change: This update improves harmonization of timing specificity across similar measures.