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Type:
Hosp Inpt eCQMs - Hospital Inpatient eCQMs
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Resolution: Resolved
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Priority:
Moderate
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Component/s: None
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None
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cms1061v1
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Not measure related
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CMS0071v15
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CMS0071v14
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CMS0071v13
Numerator criterion "Encounters With Subsequent VTE Encounter Within 30 Days PostOp" does not account for the nature of file transmission for CMS reporting. A readmission for VTE can only be satisfied if the readmission itself appears in the submitting hospital's own QRDA I file. These files are CCN- and quarter-specific. VTE events diagnosed and treated at any other facility within the 30-day window, even if the encounter occurred at a facility sharing the same EHR instance, must not be reported, thereby producing systematic false negatives. Hospitals with higher out-of-network follow-up care will appear to perform better than hospitals with high patient retention, independent of actual care quality.