Safe use of opioid follow up

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
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      Thank you for your inquiry regarding CMS506v8, Safe Use of Opioids - Concurrent Prescribing.

      CQM-8416 [[CQM-8416] Safe use of opioid follow up - Office of the National Coordinator for Health Information Technology] addresses same-facility skilled nursing level-of-service transfers, meaning swing beds. For patients admitted to an inpatient encounter and subsequently transferred to a skilled nursing level of service within the same facility, CQM-8416 states that those patients should not be included in the measure. The response explains that eCQMs are not able to differentiate patients based on level of service and instructs hospitals to work with their EHR vendor to remove these patients from the measure for purposes of reporting.

      Based on that prior guidance, if the scenario is a same-facility skilled swing bed transfer, the affected CMS506v8 encounter(s) should be removed from the reported measure population for purposes of reporting. The vendor’s statement that they do not currently have an automated way to remove these encounters may describe a product or workflow limitation, but it does not change the guidance provided in CQM-8416. We recommend asking the vendor to identify a supported workflow to ensure the affected CMS506v8 encounter(s) are not included in the reported CMS506v8 population when the CQM-8416 swing bed scenario applies.

      This removal guidance should be limited to the affected CMS506v8 encounter(s) for the same-facility skilled swing bed scenario. It should not be interpreted as a general instruction to delete the patient’s entire QRDA I file, remove the patient from other measures, or remove encounters that do not match the CQM-8416 scenario. The CMS506v8 specification identifies CMS506 as an episode-based measure, where each inpatient hospitalization or encounter ending during the measurement period is evaluated as an episode.
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      Thank you for your inquiry regarding CMS506v8, Safe Use of Opioids - Concurrent Prescribing. CQM-8416 [[ CQM-8416 ] Safe use of opioid follow up - Office of the National Coordinator for Health Information Technology] addresses same-facility skilled nursing level-of-service transfers, meaning swing beds. For patients admitted to an inpatient encounter and subsequently transferred to a skilled nursing level of service within the same facility, CQM-8416 states that those patients should not be included in the measure. The response explains that eCQMs are not able to differentiate patients based on level of service and instructs hospitals to work with their EHR vendor to remove these patients from the measure for purposes of reporting. Based on that prior guidance, if the scenario is a same-facility skilled swing bed transfer, the affected CMS506v8 encounter(s) should be removed from the reported measure population for purposes of reporting. The vendor’s statement that they do not currently have an automated way to remove these encounters may describe a product or workflow limitation, but it does not change the guidance provided in CQM-8416 . We recommend asking the vendor to identify a supported workflow to ensure the affected CMS506v8 encounter(s) are not included in the reported CMS506v8 population when the CQM-8416 swing bed scenario applies. This removal guidance should be limited to the affected CMS506v8 encounter(s) for the same-facility skilled swing bed scenario. It should not be interpreted as a general instruction to delete the patient’s entire QRDA I file, remove the patient from other measures, or remove encounters that do not match the CQM-8416 scenario. The CMS506v8 specification identifies CMS506 as an episode-based measure, where each inpatient hospitalization or encounter ending during the measurement period is evaluated as an episode.
    • cms1317v1
    • CMS0871v6
    • CMS0071v15
    • CMS0071v14
    • CMS0071v13

      Hello,

      I recently reached out about swingbed patients and if they should be included in the measure. I was told we should be working with our vendor to remove these patients since they should not count in this measure. They responded with this: 

      We do not have any way to automatically remove the identified swing bed patients from the QRDA I files (or reports or dashboards) because to the eCQM process, which is consistent with the CMS rule, a hospital admission is counted as a hospital admission, regardless of level of care or swing bed status.  

      Another issue is that you can only submit one QRDA file per patient, regardless of how many quality measures the patient qualifies for.  All qualifying measures for that patient are combined into one QRDA I file.  There is no way to remove the Safe Use of Opioid measure from the file without deleting the whole QRDA file for that patient.

       

      Can you please provide some insight, is what they are saying accurate, or should we be able to remove these patients from our populations.

       

            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Rebekah Coretti
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