[CQM-2874] CMS 165v5/NQF 0018 eSpec Mismatch from Top Portion vs Bottom Portion Created: 10/19/17  Updated: 04/30/19  Resolved: 04/30/19

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

Type: EC eCQMs - Eligible Clinicians Priority: Moderate
Reporter: Shelly Roberts (Inactive) Assignee: Mathematica EC eCQM Team (Inactive)
Resolution: Done Votes: 0
Labels: Guidance, LOGIC

Attachments: HTML File CMS165v5.html     XML File CMS165v5.xml    
Contact Name: Shelly Roberts
Contact Email: shelly.roberts@allscripts.com
Institution/Name: Allscripts
Guidance required: Interpretation of which portion of the eSpec we should be following
Solution: ​According to the Quality Data Model, when Day (date 2) >= day (date 1):

Duration (months) = (year (date 2) – year (date 1))*12 + (month (date 2) – (month (date 1))
 
If the measurement year is 2016,
 
Date 1: 1/1/2016
Date 2: 7/1/2016
 
Therefore Duration = (2016 - 2016)*12 + (7 - 1) = 6 months
 
Therefore, having "< 6 month(s) ends after or concurrent with start of" as the timing operator in the population criteria will include any visits done through the month of June. The timing in the header matches the logic.
Solution Posted On:
2017 Performance Period EC eCQMs:
CMS165v5/NQF0018
Impact: This is causing patients to not meet initial patient population

 Description   

While reviewing patients missing from initial patient population it was found that top portion and bottom portion of eSpec do not match.

I can see in prior versions that the below use to be set to "<= 6 month(s) starts after start of "Measurement Period"" .

AND: "Occurrence A of Diagnosis: Essential Hypertension" satisfies any: < 6 month(s) starts after start of "Measurement Period"
satisfies all: starts before start of "Measurement Period"
overlaps "Measurement Period"

When you review the top portion you can see that it no longer matches:
Patients 18-85 years of age who had a diagnosis of essential hypertension within the first six months of the measurement period or any time prior to the measurement period

We need to know if we should be configuring to the top portion of the eSpec for CMS 165v5 or the bottom.

Thanks,
Shelly
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