Thank you for your inquiry. We have consulted with staff at CMS, and they have indicated the measures are harmonized to the extent that they can be given the reliance upon different data sources. CMS does not require physicians to prescribe ASA if this is not appropriate. Therefore, if ASA was not prescribed due to intolerance/contraindication, then they would not be included in the numerator. The intent of the measure is to collect treatment information on those patients who have had any of the procedures listed, not for EPs to achieve 100% performance.

I am trying to improve performance on NQF 0068 as part of our Million Hearts program. NQF 0068 via PQRS appears to have a numerator exclusion (sort of) by listing two numerators, ASA or antiplatelet agent used OR ASA or antiplatelet agent not used - which implies that capturing a reason that ASA or antiplatelet is not being used - could allow me to push docs closer to 100%. However, the MU eCQM measure definition has no such 2nd numerator / numerator exclusion. My EHR vendor supplies us only with the MU defined measure (meaning no 2nd numerator). This means when I get an exceptions list per doctor, I have trouble pushing them to do better - particularly when they can respond with something such as "I have already recorded ASA and antiplatelet intolerance / contraindication - are you pushing me to inappropriately prescribe ASA?" The difference in measure definition makes it difficult to leverage reports for QI.