[CQM-2005] 6 measures use different data sets to define palliative/hospice care Created: 05/23/16  Updated: 05/30/17  Resolved: 05/30/17

Status: Closed
Project: eCQM Issue Tracker
Component/s: Measure

Type: EC eCQMs - Eligible Clinicians Priority: Minor
Reporter: Nancy Whipple (Inactive) Assignee: Mathematica EC eCQM Team (Inactive)
Resolution: Answered Votes: 0
Labels: Measure

Issue Links:
Relates
relates to CQM-2139 Modeling palliative care with ICD Closed
Contact Name: Nancy Whipple
Contact Email: nancy.whipple@ge.com
Contact Phone: 206-607-5004
Institution/Name: GE Healthcare
Solution: ​This topic was reviewed by the Change Review Panel. Please see the discussion at CQM-2139.
Solution Posted On:
2017 Performance Period EC eCQMs:
CMS69v5/NQF0421, CMS159v5/NQF0710, CMS160v5/NQF0712, CMS61v6/NQFna, CMS64v6/NQFna, CMS149v5/NQFna
If your issue is regarding an older eCQM version, enter it here: 1546
Impact: difficulty to have consistent logic for measures with different value sets for the same data criteria
Comment Posted On:
Date Voting Opened:
Last Commented Date:

 Description   

Currently there are 6 measures that reference palliative and/or hospice care. They are: 61, 64, 69, 149, 159, 160.

The Measures refer to Palliative care as either a procedure or an intervention. This is inconsistent and does not appear to be necessary for determining exclusions.

149, 159, and 160 Refer to Palliative Care:

"Intervention, Performed: Palliative Care" using "Palliative Care Grouping Value Set (2.16.840.1.113883.3.526.3.1024)"

61, 64, and 69 Refer to Palliative Care:
"Procedure, Order: Palliative Care" using "Palliative Care Grouping Value Set (2.16.840.1.113883.3.600.1.1579)"

61,64, and 69 all reference NLM Value Set
Palliative Care: 2.16.840.1.113883.3.600.1.1579
Encounter for Palliative Care Z51.5 (ICD-10)
Encounter for Palliative Care V66.7 (ICD-9)
Admission by palliative care physician 305284002 (SNOMED Procedure)
Admission to palliative care physician 305381007 (SNOMED Procedure)
Comfort Measures 133918004 (SNOMED Regime/Therapy)
Dying Care 385736008 (SNOMED Regime/Therapy)
Hospice Care 385763009 (SNOMED Regime/Therapy)
Referral by palliative care physician 305981001 (SNOMED Procedure)
Referral to palliative care physician 306288008 (SNOMED Procedure)
Referral by palliative care service 306237005 (SNOMED Procedure)
Terminal care 182964004) (SNOMED Regime/Therapy)

149 and 160 reference NLM Value Set:
Palliative Care: 2.16.840.1.113883.3.526.3.1024
Palliative Care 103735009
Hospice Care 385763009

Recommendations:
• To use the same NLM value set for all instances where Palliative Care is in the criteria and that the value set selected should be Palliative Care: 2.16.840.1.113883.3.600.1.1579.
• Add Palliative Care 103735009 to the 2.16.840.1.113883.3.600.1.1579 value set.



 Comments   
Comment by Mathematica EC eCQM Team (Inactive) [ 05/30/17 ]

This issue has been addressed in the 2017 Annual Update.

Comment by Mathematica EC eCQM Team (Inactive) [ 06/24/16 ]

We are looking at harmonization efforts and we will provide an update later this summer

Comment by Anecia Suneja (Inactive) [ 06/20/16 ]

STK2 looks at discharge disposition to hospice. Is there any timeframe for finding evidence of hospice (e.g. 30 days after discharge the patient was admitted into hospice)?

Comment by Mathematica EC eCQM Team (Inactive) [ 06/03/16 ]

Thank you for the suggestion. The measure developers will be discussing harmonization opportunities this summer.

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