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  1. eCQM Issue Tracker
  2. CQM-6703

ePC-07 Missing Risk Adjustment Variables

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      Thank you for your inquiry about CMS1028/PC-07 Severe Obstetric Complications. These risk factors were discussed with our technical advisory panel (TAP), and it was felt that due to the variability seen in cases of fibroids, previous hemorrhage, and birth weight over 4000 grams, these conditions should not be included. As far as grand multiparity, studies are conflicting, with some finding that nulliparous women have higher rates of SMM. The measure was designed to remove cases from the numerator if blood transfusion was the only numerator condition met and provide a stratified measure rate for the numerator cases with these removed.
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      Thank you for your inquiry about CMS1028/PC-07 Severe Obstetric Complications. These risk factors were discussed with our technical advisory panel (TAP), and it was felt that due to the variability seen in cases of fibroids, previous hemorrhage, and birth weight over 4000 grams, these conditions should not be included. As far as grand multiparity, studies are conflicting, with some finding that nulliparous women have higher rates of SMM. The measure was designed to remove cases from the numerator if blood transfusion was the only numerator condition met and provide a stratified measure rate for the numerator cases with these removed.
    • CMS1028v2
    • Without these considerations, this publicly reported measure doesn't adequately consider risk factors we commonly see in our patient population that might affect our rate of blood administration.

      We've been tracking our data for ePC-07 for the last year and we are wondering why there aren't more risk adjustment factors considered, especially for postpartum hemorrhage risk factors that might lead to a blood transfusion. We would like to suggest that the following risk factors be added as part of the risk adjustment for ePC-07:

      birthweight over 4000 grams

      previous hx of postpartum hemorrhage

      grand multiparity

      uterine fibroids.

      Without these considerations, this publicly reported measure doesn't adequately consider risk factors we commonly see in our patient population that might affect our rate of blood administration.

            JLeflore Mathematica EH eCQM Team
            jlharlos Jennifer Harlos
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