eCQM: Functional Status Assessments for Congestive Heart Failure (CMS 90v6)


eCQM:

Functional Status Assessments for Congestive Heart Failure

CMS ID:

CMS 90v6

Measure Type:

Process

MIPS High Priority Measure:

Yes

Quality ID:

377

Eligible for Quality Programs:

  • Merit-Based Incentive Payment System (MIPS)
  • Medicaid EHR Incentive Program (Meaningful Use)

Performance Benchmark for MIPS:

No historic benchmark exists for this measure. For measures with no historic benchmark, MIPS will attempt to calculate benchmarks based on 2017 performance data. If no historic benchmark exists and no benchmark can be calculated, the measure will receive 3 points if performance data is submitted.

Description:

Percentage of patients 65 years of age and older with congestive heart failure who completed initial and follow-up patient-reported functional status assessments.

  • Numerator: Patients with patient reported functional status assessment results (e.g., VR-12; VR-36; MLHF-Q; KCCQ; PROMIS-10 Global Health, PROMIS-29) present in the EHR within two weeks before or during the initial encounter and within two weeks before or during the follow-up encounter during the measurement year.
  • Denominator: Patients 65 years of age and older who had two eligible outpatient encounters (defined as a signed chart note with one of the following encounter types: Office Visit, Nurse Visit, Home Visit or Nursing Home Visit) during the measurement year and a diagnosis of congestive heart failure.
    • Denominator Exclusions: Patients with severe cognitive impairment or patients with a diagnosis of cancer.

    • Denominator Exceptions: None

eCQM Patient Reports

eCQM Patient Reports can help you identify patient care gaps and improve the performance of your quality measures. Click on the blue result numbers in the eCQM Dashboard to see the patient report for this measure.

The eCQM Patient Reports list the individual patients included in the measure’s population, which measure cohorts the patient is in, and contact information for the patient to streamline any downstream communication that may be needed to fulfill the measure requirements. You can choose to print the patient list for a measure or export it as a CSV.

The measure cohorts included in the eCQM Patient Report for CMS 90v6 Functional Status Assessment for Congestive Heart Failure are:

  • Initial patient population
  • Denominator
  • Numerator
  • Exclusion

Practice Fusion Suggested Workflow
Practice Fusion suggests the following workflow to help ensure that you are able to meet the requirements of this measure within the Practice Fusion EHR.

  1. Ensure that patients with congestive heart failure have an appropriate diagnosis, with a start date, recorded in the medical record. Examples of congestive heart failure diagnosis codes that can be used for this measure can be found in Table 1.

  2. Ensure that patient reported functional status assessment results are present in the EHR within two weeks before or during the initial encounter AND within two weeks before or during the follow-up encounter.

    1. Examples of appropriate functional status assessments can be found in Table 1.

    2. Refer to the suggested workflow in Table 2 to record the assessment details.

Table 1: Examples of Measure Criteria for CMS 90v6

Data Type

Example Codes

Congestive Heart Failure Diagnosis Codes

  • I11.0 (ICD-10)
  • I50.22 (ICD-10)
  • I50.41 (ICD-10)
  • I50.43 (ICD-10)

Functional Status Assessment

  • PROMIS-10 Global Health
  • PROMIS-29
  • VR-12
  • VR-36
  • MLHF-Q
  • KCCQ
Table 2: Practice Fusion Suggested Workflow to Record Functional Status Assessments

Data Type

Practice Fusion Suggested Workflow

Functional Status Assessment
(
Per the measure requirements, The same FSA instrument must be used for the initial and follow-up assessment.)

  • At each eligible outpatient visit, In the Screenings/Interventions/Assessments section of the encounter, search for the assessment that was completed and select the item. Examples include:

    • PROMIS-10 Global health - GMH - raw score (LOINC 71970-8)

    • Overall summary score of KCCQ (LOINC 71940-1)

  • Once selected, record and save the following information in the modal window that opens:

    • Status: Performed

    • Start Date: Date the assessment was performed

Additional Measure Information
  • This 2016 measure version has been updated from the previous 2015 version specifications, incorporating the following change:

    • Updated the measure description to align with the measure intent.

    • Added the word 'days' after 180 to clarify the unit. Added guidance to indicate the same FSA instrument should be used. Removed the statement about QRDA as it is not pertinent to the measure calculation.

    • Updated the initial population description to align with the measure intent.

    • Updated the measure name to reflect the measure intent.

  • To be recognized for the denominator exclusion, the patient must have an active diagnosis of cancer recorded in his or her chart (a complete list of codes can be found on the USHIK website).

  • For the purposes of this measure, CMS defines the Initial encounter as the first encounter during the first 185 days of the measurement year and the follow-up encounter as the last encounter that is at least 30 days but no more than 180 days after the initial encounter.

  • A Functional Status Assessment (FSA) is based on administration of a validated instrument to eligible patients that asks patients to answer questions related to various domains including: pain, physical function, emotional well-being, health-related quality of life, symptom acuity.

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