[ { "title": "Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)", "eMeasureId": "CMS122v10", "nqfEMeasureId": null, "nqfId": "0059", "measureId": "001", "description": "Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "intermediateOutcome", "isHighPriority": true, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": true, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf", "app1" ], "submissionMethods": [ "claims", "electronicHealthRecord", "cmsWebInterface", "registry" ], "measureSets": [ "endocrinology", "familyMedicine", "internalMedicine", "nephrology", "preventiveMedicine" ], "measureSpecification": {} }, { "title": "Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)", "eMeasureId": "CMS135v10", "nqfEMeasureId": "0081e", "nqfId": "0081", "measureId": "005", "description": "Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) < 40% who were prescribed ACE inhibitor or ARB or ARNI therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Heart Association", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord", "registry" ], "measureSets": [ "cardiology", "familyMedicine", "hospitalists", "internalMedicine" ], "measureSpecification": {} }, { "title": "Coronary Artery Disease (CAD): Antiplatelet Therapy", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "0067", "measureId": "006", "description": "Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease (CAD) seen within a 12-month period who were prescribed aspirin or clopidogrel.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Heart Association", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "cardiology", "familyMedicine", "internalMedicine", "skilledNursingFacility" ], "measureSpecification": {} }, { "title": "Coronary Artery Disease (CAD): Beta-Blocker Therapy - Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF < 40%)", "eMeasureId": "CMS145v10", "nqfEMeasureId": "0070e", "nqfId": "0070", "measureId": "007", "description": "Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12-month period who also have a prior MI or a current or prior LVEF < 40% who were prescribed beta-blocker therapy.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Heart Association", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord", "registry" ], "measureSets": [ "cardiology", "familyMedicine", "internalMedicine", "skilledNursingFacility" ], "measureSpecification": {} }, { "title": "Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)", "eMeasureId": "CMS144v10", "nqfEMeasureId": "0083e", "nqfId": "0083", "measureId": "008", "description": "Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) < 40% who were prescribed beta-blocker therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Heart Association", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord", "registry" ], "measureSets": [ "cardiology", "familyMedicine", "hospitalists", "internalMedicine", "skilledNursingFacility" ], "measureSpecification": {} }, { "title": "Anti-Depressant Medication Management", "eMeasureId": "CMS128v10", "nqfEMeasureId": null, "nqfId": null, "measureId": "009", "description": "Percentage of patients 18 years of age and older who were treated with antidepressant medication, had a diagnosis of major depression, and who remained on an antidepressant medication treatment. Two rates are reported. a. Percentage of patients who remained on an antidepressant medication for at least 84 days (12 weeks). b. Percentage of patients who remained on an antidepressant medication for at least 180 days (6 months).", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "overallAlgorithm": "simpleAverage", "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "multiPerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord" ], "measureSets": [ "familyMedicine", "internalMedicine", "mentalBehavioralHealth" ], "measureSpecification": {}, "strata": [ { "name": ">=84Days", "description": "Percentage of patients who remained on an antidepressant medication for at least 84 days (12 weeks)." }, { "name": ">=180Days", "description": "Percentage of patients who remained on an antidepressant medication for at least 180 days (6 months)" } ] }, { "title": "Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation", "eMeasureId": "CMS143v10", "nqfEMeasureId": "0086e", "nqfId": null, "measureId": "012", "description": "Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Academy of Ophthalmology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord" ], "measureSets": [ "ophthalmology" ], "measureSpecification": {} }, { "title": "Age-Related Macular Degeneration (AMD): Dilated Macular Examination", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "0087", "measureId": "014", "description": "Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage AND the level of macular degeneration severity during one or more office visits within the 12 month performance period.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Academy of Ophthalmology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "ophthalmology" ], "measureSpecification": {} }, { "title": "Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care", "eMeasureId": "CMS142v10", "nqfEMeasureId": null, "nqfId": null, "measureId": "019", "description": "Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the findings of the macular or fundus exam at least once within 12 months.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "American Academy of Ophthalmology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord", "registry" ], "measureSets": [ "ophthalmology" ], "measureSpecification": {} }, { "title": "Communication with the Physician or Other Clinician Managing On-Going Care Post-Fracture for Men and Women Aged 50 Years and Older", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "024", "description": "Percentage of patients aged 50 years and older treated for a fracture with documentation of communication, between the physician treating the fracture and the physician or other clinician managing the patient's on-going care, that a fracture occurred and that the patient was or should be considered for osteoporosis treatment or testing. This measure is submitted by the physician who treats the fracture and who therefore is held accountable for the communication.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "claims", "registry" ], "measureSets": [ "familyMedicine", "internalMedicine", "orthopedicSurgery", "preventiveMedicine", "rheumatology" ], "measureSpecification": {} }, { "title": "Screening for Osteoporosis for Women Aged 65-85 Years of Age", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "0046", "measureId": "039", "description": "Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "claims", "registry" ], "measureSets": [ "endocrinology", "familyMedicine", "geriatrics", "internalMedicine", "preventiveMedicine", "rheumatology" ], "measureSpecification": {} }, { "title": "Advance Care Plan", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "0326", "measureId": "047", "description": "Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record or documentation in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "claims", "registry" ], "measureSets": [ "cardiology", "certifiedNurseMidwife", "clinicalSocialWork", "familyMedicine", "gastroenterology", "generalSurgery", "geriatrics", "hospitalists", "internalMedicine", "nephrology", "neurology", "obstetricsGynecology", "oncology", "orthopedicSurgery", "otolaryngology", "physicalMedicine", "preventiveMedicine", "pulmonology", "rheumatology", "skilledNursingFacility", "thoracicSurgery", "urology", "vascularSurgery" ], "measureSpecification": {} }, { "title": "Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "048", "description": "Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "familyMedicine", "geriatrics", "internalMedicine", "obstetricsGynecology", "preventiveMedicine", "urology" ], "measureSpecification": {} }, { "title": "Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "050", "description": "Percentage of female patients aged 65 years and older with a diagnosis of urinary incontinence with a documented plan of care for urinary incontinence at least once within 12 months.", "nationalQualityStrategyDomain": "Person and Caregiver-Centered Experience and Outcomes", "measureType": "process", "isHighPriority": true, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "familyMedicine", "geriatrics", "internalMedicine", "obstetricsGynecology", "physicalTherapyOccupationalTherapy", "urology" ], "measureSpecification": {} }, { "title": "Chronic Obstructive Pulmonary Disease (COPD): Long-Acting Inhaled Bronchodilator Therapy", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "0102", "measureId": "052", "description": "Percentage of patients aged 18 years and older with a diagnosis of COPD (FEV1/FVC < 70%) and who have an FEV1 less than 60% predicted and have symptoms who were prescribed a long-acting inhaled bronchodilator.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Thoracic Society", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "pulmonology" ], "measureSpecification": {} }, { "title": "Appropriate Treatment for Upper Respiratory Infection (URI)", "eMeasureId": "CMS154v10", "nqfEMeasureId": null, "nqfId": "0069", "measureId": "065", "description": "Percentage of episodes for patients 3 months of age and older with a diagnosis of upper respiratory infection (URI) that did not result in an antibiotic dispensing event.", "nationalQualityStrategyDomain": "Efficiency and Cost Reduction", "measureType": "process", "isHighPriority": true, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord", "registry" ], "measureSets": [ "familyMedicine", "otolaryngology", "pediatrics", "urgentCare" ], "measureSpecification": {} }, { "title": "Appropriate Testing for Pharyngitis", "eMeasureId": "CMS146v10", "nqfEMeasureId": null, "nqfId": null, "measureId": "066", "description": "The percentage of episodes for patients 3 years and older with a diagnosis of pharyngitis that resulted in an antibiotic dispensing event and a group A streptococcus (strep) test.", "nationalQualityStrategyDomain": "Efficiency and Cost Reduction", "measureType": "process", "isHighPriority": true, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord", "registry" ], "measureSets": [ "emergencyMedicine", "familyMedicine", "pediatrics", "urgentCare" ], "measureSpecification": {} }, { "title": "Prevention of Central Venous Catheter (CVC) - Related Bloodstream Infections", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "2726", "measureId": "076", "description": "Percentage of patients, regardless of age, who undergo central venous catheter (CVC) insertion for whom CVC was inserted with all elements of maximal sterile barrier technique, hand hygiene, skin preparation and, if ultrasound is used, sterile ultrasound techniques followed.", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "process", "isHighPriority": true, "primarySteward": "American Society of Anesthesiologists", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "claims", "registry" ], "measureSets": [ "anesthesiology", "hospitalists", "interventionalRadiology" ], "measureSpecification": {} }, { "title": "Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy - Avoidance of Inappropriate Use", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "0654", "measureId": "093", "description": "Percentage of patients aged 2 years and older with a diagnosis of AOE who were not prescribed systemic antimicrobial therapy.", "nationalQualityStrategyDomain": "Efficiency and Cost Reduction", "measureType": "process", "isHighPriority": true, "primarySteward": "American Academy of Otolaryngology - Head and Neck Surgery", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "emergencyMedicine", "familyMedicine", "internalMedicine", "otolaryngology", "pediatrics", "urgentCare" ], "measureSpecification": {} }, { "title": "Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients", "eMeasureId": "CMS129v11", "nqfEMeasureId": "0389e", "nqfId": "0389", "measureId": "102", "description": "Percentage of patients, regardless of age, with a diagnosis of prostate cancer at low (or very low) risk of recurrence receiving interstitial prostate brachytherapy, OR external beam radiotherapy to the prostate, OR radical prostatectomy who did not have a bone scan performed at any time since diagnosis of prostate cancer.", "nationalQualityStrategyDomain": "Efficiency and Cost Reduction", "measureType": "process", "isHighPriority": true, "primarySteward": "Centers for Medicare & Medicaid Services", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord", "registry" ], "measureSets": [ "oncology", "radiationOncology", "urology" ], "measureSpecification": {} }, { "title": "Prostate Cancer: Combination Androgen Deprivation Therapy for High Risk or Very High Risk Prostate Cancer", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "0390", "measureId": "104", "description": "Percentage of patients, regardless of age, with a diagnosis of prostate cancer at high or very high risk of recurrence receiving external beam radiotherapy to the prostate who were prescribed androgen deprivation therapy in combination with external beam radiotherapy to the prostate.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Urological Association Education and Research", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "urology" ], "measureSpecification": {} }, { "title": "Adult Major Depressive Disorder (MDD): Suicide Risk Assessment", "eMeasureId": "CMS161v10", "nqfEMeasureId": "0104e", "nqfId": null, "measureId": "107", "description": "All patient visits during which a new diagnosis of MDD or a new diagnosis of recurrent MDD was identified for patients aged 18 years and older with a suicide risk assessment completed during the visit.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "Mathematica", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord" ], "measureSets": [ "emergencyMedicine", "familyMedicine", "internalMedicine", "mentalBehavioralHealth" ], "measureSpecification": {} }, { "title": "Preventive Care and Screening: Influenza Immunization", "eMeasureId": "CMS147v11", "nqfEMeasureId": "0041e", "nqfId": "0041", "measureId": "110", "description": "Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization.", "nationalQualityStrategyDomain": "Community/Population Health", "measureType": "process", "isHighPriority": false, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "claims", "electronicHealthRecord", "cmsWebInterface", "registry" ], "measureSets": [ "allergyImmunology", "cardiology", "certifiedNurseMidwife", "endocrinology", "familyMedicine", "geriatrics", "infectiousDisease", "internalMedicine", "nephrology", "obstetricsGynecology", "oncology", "otolaryngology", "pediatrics", "preventiveMedicine", "pulmonology", "rheumatology", "skilledNursingFacility" ], "measureSpecification": {} }, { "title": "Pneumococcal Vaccination Status for Older Adults", "eMeasureId": "CMS127v10", "nqfEMeasureId": null, "nqfId": null, "measureId": "111", "description": "Percentage of patients 66 years of age and older who have ever received a pneumococcal vaccine.", "nationalQualityStrategyDomain": "Community/Population Health", "measureType": "process", "isHighPriority": false, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "claims", "electronicHealthRecord", "registry" ], "measureSets": [ "allergyImmunology", "cardiology", "endocrinology", "familyMedicine", "geriatrics", "infectiousDisease", "internalMedicine", "nephrology", "obstetricsGynecology", "oncology", "otolaryngology", "preventiveMedicine", "pulmonology", "rheumatology", "skilledNursingFacility" ], "measureSpecification": {} }, { "title": "Breast Cancer Screening", "eMeasureId": "CMS125v10", "nqfEMeasureId": null, "nqfId": "2372", "measureId": 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"icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "claims", "registry" ], "measureSets": [ "audiology", "clinicalSocialWork", "familyMedicine", "geriatrics", "internalMedicine", "mentalBehavioralHealth", "neurology", "nutritionDietician", "physicalTherapyOccupationalTherapy", "skilledNursingFacility", "speechLanguagePathology" ], "measureSpecification": {} }, { "title": "Functional Outcome Assessment", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "182", "description": "Percentage of visits for patients aged 18 years and older with documentation of a current functional outcome assessment using a standardized functional outcome assessment tool on the date of the encounter AND documentation of a care plan based on identified functional outcome deficiencies on the date of the identified deficiencies.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "Centers for Medicare & Medicaid Services", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "audiology", "chiropracticMedicine", "familyMedicine", "nephrology", "orthopedicSurgery", "physicalMedicine", "physicalTherapyOccupationalTherapy", "preventiveMedicine", "speechLanguagePathology" ], "measureSpecification": {} }, { "title": "Colonoscopy Interval for Patients with a History of Adenomatous Polyps - Avoidance of Inappropriate Use", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "185", "description": "Percentage of patients aged 18 years and older receiving a surveillance colonoscopy, with a history of prior adenomatous polyp(s) in previous colonoscopy findings, which had an interval of 3 or more years since their last colonoscopy.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "American Gastroenterological Association", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "gastroenterology" ], "measureSpecification": {} }, { "title": "Stroke and Stroke Rehabilitation: Thrombolytic Therapy", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "187", "description": "Percentage of patients aged 18 years and older with a diagnosis of acute ischemic stroke who arrive at the hospital within two hours of time last known well and for whom IV alteplase was initiated within three hours of time last known well.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Heart Association", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "emergencyMedicine", "neurosurgical" ], "measureSpecification": {} }, { "title": "Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery", "eMeasureId": "CMS133v10", "nqfEMeasureId": "0565e", "nqfId": "0565", "measureId": "191", "description": "Percentage of cataract surgeries for patients aged 18 years and older with a diagnosis of uncomplicated cataract and no significant ocular conditions impacting the visual outcome of surgery and had best-corrected visual acuity of 20/40 or better (distance or near) achieved in the operative eye within 90 days following the cataract surgery.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "outcome", "isHighPriority": true, "primarySteward": "American Academy of Ophthalmology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord", "registry" ], "measureSets": [ "ophthalmology" ], "measureSpecification": {} }, { "title": "HIV/AIDS: Sexually Transmitted Disease Screening for Chlamydia, Gonorrhea, and Syphilis", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "0409", "measureId": "205", "description": "Percentage of patients aged 13 years and older with a diagnosis of HIV/AIDS for whom chlamydia, gonorrhea, and syphilis screenings were performed at least once since the diagnosis of HIV infection.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "Health Resources and Services Administration", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "infectiousDisease", "pediatrics" ], "measureSpecification": {} }, { "title": "Functional Status Change for Patients with Knee Impairments", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "217", "description": "A patient-reported outcome measure of risk-adjusted change in functional status for patients 14 years+ with knee impairments. The change in functional status (FS) is assessed using the FOTO Lower Extremity Physical Function (LEPF) patient-reported outcome measure (PROM). The measure is adjusted to patient characteristics known to be associated with FS outcomes (risk-adjusted) and used as a performance measure at the patient level, at the individual clinician level, and at the clinic level to assess quality. The measure is available as a computer adaptive test, for reduced patient burden, or a short form (static measure).", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "patientReportedOutcome", "isHighPriority": true, "primarySteward": "Focus on Therapeutic Outcomes, Inc.", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "chiropracticMedicine", "orthopedicSurgery", "physicalTherapyOccupationalTherapy" ], "measureSpecification": {} }, { "title": "Functional Status Change for Patients with Hip Impairments", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "218", "description": "A patient-reported outcome measure of risk-adjusted change in functional status for patients 14 years+ with hip impairments. The change in functional status (FS) is assessed using the FOTO Lower Extremity Physical Function (LEPF) patient-reported outcome measure (PROM). The measure is adjusted to patient characteristics known to be associated with FS outcomes (risk adjusted) and used as a performance measure at the patient level, at the individual clinician level, and at the clinic level to assess quality. The measure is available as a computer adaptive test, for reduced patient burden, or a short form (static measure).", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "patientReportedOutcome", "isHighPriority": true, "primarySteward": "Focus on Therapeutic Outcomes, Inc.", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "chiropracticMedicine", "orthopedicSurgery", "physicalTherapyOccupationalTherapy" ], "measureSpecification": {} }, { "title": "Functional Status Change for Patients with Lower Leg, Foot or Ankle Impairments", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "219", "description": "A patient-reported outcome measure of risk-adjusted change in functional status for patients 14 years+ with foot, ankle or lower leg impairments. The change in functional status (FS) is assessed using the FOTO Lower Extremity Physical Function (LEPF) patient- reported outcome measure (PROM). The measure is adjusted to patient characteristics known to be associated with FS outcomes (risk-adjusted) and used as a performance measure at the patient level, at the individual clinician level, and at the clinic level to assess quality. The measure is available as a computer adaptive test, for reduced patient burden, or a short form (static measure).", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "patientReportedOutcome", "isHighPriority": true, "primarySteward": "Focus on Therapeutic Outcomes, Inc.", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "chiropracticMedicine", "orthopedicSurgery", "physicalTherapyOccupationalTherapy" ], "measureSpecification": {} }, { "title": "Functional Status Change for Patients with Low Back Impairments", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "220", "description": "A patient-reported outcome measure of risk-adjusted change in functional status for patients 14 years+ with low back impairments. The change in functional status (FS) is assessed using the FOTO Low Back FS patient-reported outcome measure (PROM). The measure is adjusted to patient characteristics known to be associated with FS outcomes (risk adjusted) and used as a performance measure at the patient level, at the individual clinician level, and at the clinic level to assess quality. The measure is available as a computer adaptive test, for reduced patient burden, or a short form (static measure).", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "patientReportedOutcome", "isHighPriority": true, "primarySteward": "Focus on Therapeutic Outcomes, Inc.", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "chiropracticMedicine", "orthopedicSurgery", "physicalTherapyOccupationalTherapy" ], "measureSpecification": {} }, { "title": "Functional Status Change for Patients with Shoulder Impairments", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "221", "description": "A patient-reported outcome measure of risk-adjusted change in functional status for patients 14 years+ with shoulder impairments. The change in functional status (FS) is assessed using the FOTO Shoulder FS patient-reported outcome measure (PROM). The measure is adjusted to patient characteristics known to be associated with FS outcomes (risk adjusted) and used as a performance measure at the patient level, at the individual clinician level, and at the clinic level to assess quality. The measure is available as a computer adaptive test, for reduced patient burden, or a short form (static measure).", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "patientReportedOutcome", "isHighPriority": true, "primarySteward": "Focus on Therapeutic Outcomes, Inc.", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "chiropracticMedicine", "orthopedicSurgery", "physicalTherapyOccupationalTherapy" ], "measureSpecification": {} }, { "title": "Functional Status Change for Patients with Elbow, Wrist or Hand Impairments", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "222", "description": "A patient-reported outcome measure of risk-adjusted change in functional status for patients 14 years+ with elbow, wrist, or hand impairments. The change in functional status (FS) is assessed using the FOTO Elbow/Wrist/Hand FS patient-reported outcome measure (PROM). The measure is adjusted to patient characteristics known to be associated with FS outcomes (risk adjusted) and used as a performance measure at the patient level, at the individual clinician level, and at the clinic level to assess quality. The measure is available as a computer adaptive test, for reduced patient burden, or a short form (static measure).", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "patientReportedOutcome", "isHighPriority": true, "primarySteward": "Focus on Therapeutic Outcomes, Inc.", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "chiropracticMedicine", "orthopedicSurgery", "physicalTherapyOccupationalTherapy" ], "measureSpecification": {} }, { "title": "Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention", "eMeasureId": "CMS138v10", "nqfEMeasureId": "0028e", "nqfId": "0028", "measureId": "226", "description": "Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within the measurement period AND who received tobacco cessation intervention on the date of the encounter or within the previous 12 months if identified as a tobacco user.Three rates are reported:a. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within the measurement period.b. Percentage of patients aged 18 years and older who were identified as a tobacco user who received tobacco cessation intervention on the date of the encounter or within the previous 12 months.c. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times during the measurement period AND who received tobacco cessation intervention if identified as a tobacco user on the date of the encounter or within the previous 12 months.", "nationalQualityStrategyDomain": "Community/Population Health", "measureType": "process", "isHighPriority": false, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "overallAlgorithm": "overallStratumOnly", "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "multiPerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "claims", "electronicHealthRecord", "cmsWebInterface", "registry" ], "measureSets": [ "allergyImmunology", "audiology", "cardiology", "certifiedNurseMidwife", "clinicalSocialWork", "dermatology", "endocrinology", "familyMedicine", "gastroenterology", "generalSurgery", "internalMedicine", "mentalBehavioralHealth", "neurology", "neurosurgical", "obstetricsGynecology", "oncology", "ophthalmology", "orthopedicSurgery", "otolaryngology", "physicalMedicine", "physicalTherapyOccupationalTherapy", "plasticSurgery", "podiatry", "preventiveMedicine", "pulmonology", "rheumatology", "speechLanguagePathology", "thoracicSurgery", "urgentCare", "urology", "vascularSurgery" ], "measureSpecification": {}, "strata": [ { "name": "screenedForUse", "description": "Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within the measurement period" }, { "name": "overall", "description": "Percentage of patients aged 18 years and older who were identified as a tobacco user who received tobacco cessation intervention on the date of the encounter or within the previous 12 months" }, { "name": "tobacco", "description": "Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within the measurement period AND who received tobacco cessation intervention if identified as a tobacco user on the date of the encounter or within the previous 12 months" } ] }, { "title": "Controlling High Blood Pressure", "eMeasureId": "CMS165v10", "nqfEMeasureId": null, "nqfId": null, "measureId": "236", "description": "Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (<140/90mmHg) during the measurement period.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "intermediateOutcome", "isHighPriority": true, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf", "app1" ], "submissionMethods": [ "claims", "electronicHealthRecord", "cmsWebInterface", "registry" ], "measureSets": [ "cardiology", "endocrinology", "familyMedicine", "internalMedicine", "obstetricsGynecology", "pulmonology", "rheumatology", "vascularSurgery" ], "measureSpecification": {} }, { "title": "Use of High-Risk Medications in Older Adults", "eMeasureId": "CMS156v10", "nqfEMeasureId": null, "nqfId": "0022", "measureId": "238", "description": "Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class.", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "process", "isHighPriority": true, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": true, "overallAlgorithm": "overallStratumOnly", "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "multiPerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord", "registry" ], "measureSets": [ "allergyImmunology", "cardiology", "familyMedicine", "geriatrics", "internalMedicine", "ophthalmology", "pulmonology", "rheumatology", "skilledNursingFacility" ], "measureSpecification": {}, "strata": [ { "name": "overall", "description": "Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class." }, { "name": "diagnosisException", "description": "Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class, except for appropriate diagnoses." }, { "name": "eCQMTotalRate", "description": "Total rate (the sum of the two numerators divided by the denominator, deduplicating for patients in both numerators)." } ] }, { "title": "Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents", "eMeasureId": "CMS155v10", "nqfEMeasureId": null, "nqfId": null, "measureId": "239", "description": "Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported. Percentage of patients with height, weight, and body mass index (BMI) percentile documentation. Percentage of patients with counseling for nutrition. Percentage of patients with counseling for physical activity.", "nationalQualityStrategyDomain": "Community/Population Health", "measureType": "process", "isHighPriority": false, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "overallAlgorithm": "simpleAverage", "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "multiPerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord" ], "measureSets": [ "nutritionDietician", "pediatrics" ], "measureSpecification": {}, "strata": [ { "name": "BMI", "description": "Patients who had a height, weight and body mass index (BMI) percentile recorded during the measurement period" }, { "name": "nutrition", "description": "Patients who had counseling for nutrition during a visit that occurs during the measurement period" }, { "name": "physicalActivity", "description": "Patients who had counseling for physical activity during a visit that occurs during the measurement period" } ] }, { "title": "Childhood Immunization Status", "eMeasureId": "CMS117v10", "nqfEMeasureId": null, "nqfId": null, "measureId": "240", "description": "Percentage of children 2 years of age who had four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV), one measles, mumps and rubella (MMR); three or four H influenza type B (HiB); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday.", "nationalQualityStrategyDomain": "Community/Population Health", "measureType": "process", "isHighPriority": false, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord" ], "measureSets": [ "pediatrics" ], "measureSpecification": {} }, { "title": "Cardiac Rehabilitation Patient Referral from an Outpatient Setting", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "0643", "measureId": "243", "description": "Percentage of patients evaluated in an outpatient setting who within the previous 12 months have experienced an acute myocardial infarction (MI), coronary artery bypass graft (CABG) surgery, a percutaneous coronary intervention (PCI), cardiac valve surgery, or cardiac transplantation, or who have chronic stable angina (CSA) and have not already participated in an early outpatient cardiac rehabilitation/secondary prevention (CR) program for the qualifying event/diagnosis who were referred to a CR program.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "American Heart Association", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "cardiology", "familyMedicine", "internalMedicine" ], "measureSpecification": {} }, { "title": "Barrett's Esophagus", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "249", "description": "Percentage of esophageal biopsy reports that document the presence of Barrett's mucosa that also include a statement about dysplasia.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "College of American Pathologists", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "claims", "registry" ], "measureSets": [ "pathology" ], "measureSpecification": {} }, { "title": "Radical Prostatectomy Pathology Reporting", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "250", "description": "Percentage of radical prostatectomy pathology reports that include the pT category, the pN category, the Gleason score and a statement about margin status.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "College of American Pathologists", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "claims", "registry" ], "measureSets": [ "oncology", "pathology" ], "measureSpecification": {} }, { "title": "Ultrasound Determination of Pregnancy Location for Pregnant Patients with Abdominal Pain", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "254", "description": "Percentage of pregnant female patients aged 14 to 50 who present to the emergency department (ED) with a chief complaint of abdominal pain or vaginal bleeding who receive a trans-abdominal or trans-vaginal ultrasound to determine pregnancy location.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American College of Emergency Physicians", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "emergencyMedicine" ], "measureSpecification": {} }, { "title": "Rate of Open Repair of Small or Moderate Non-Ruptured Infrarenal Abdominal Aortic Aneurysms (AAA) without Major Complications (Discharged to Home by Post-Operative Day #7)", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "258", "description": "Percent of patients undergoing open repair of small or moderate sized non-ruptured infrarenal abdominal aortic aneurysms (AAA) who do not experience a major complication (discharge to home no later than post-operative day #7).", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "outcome", "isHighPriority": true, "primarySteward": "Society for Vascular Surgeons", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "vascularSurgery" ], "measureSpecification": {} }, { "title": "Rate of Endovascular Aneurysm Repair (EVAR) of Small or Moderate Non-Ruptured Infrarenal Abdominal Aortic Aneurysms (AAA) without Major Complications (Discharged to Home by Post-Operative Day #2)", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "259", "description": "Percent of patients undergoing endovascular repair of small or moderate non-ruptured infrarenal abdominal aortic aneurysms (AAA) that do not experience a major complication (discharged to home no later than post-operative day #2).", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "outcome", "isHighPriority": true, "primarySteward": "Society for Vascular Surgeons", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "vascularSurgery" ], "measureSpecification": {} }, { "title": "Rate of Carotid Endarterectomy (CEA) for Asymptomatic Patients, without Major Complications (Discharged to Home by Post-Operative Day #2)", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "260", "description": "Percent of asymptomatic patients undergoing Carotid Endarterectomy (CEA) who are discharged to home no later than post-operative day #2.", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "outcome", "isHighPriority": true, "primarySteward": "Society for Vascular Surgeons", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "neurosurgical", "vascularSurgery" ], "measureSpecification": {} }, { "title": "Referral for Otologic Evaluation for Patients with Acute or Chronic Dizziness", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "261", "description": "Percentage of patients aged birth and older referred to a physician (preferably a physician specially trained in disorders of the ear) for an otologic evaluation subsequent to an audiologic evaluation after presenting with acute or chronic dizziness.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "Audiology Quality Consortium", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "claims", "registry" ], "measureSets": [ "audiology" ], "measureSpecification": {} }, { "title": "Sentinel Lymph Node Biopsy for Invasive Breast Cancer", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "264", "description": "The percentage of clinically node negative (clinical stage T1N0M0 or T2N0M0) breast cancer patients before or after neoadjuvant systemic therapy, who undergo a sentinel lymph node (SLN) procedure.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Society of Breast Surgeons", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "generalSurgery" ], "measureSpecification": {} }, { "title": "Biopsy Follow-Up", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "265", "description": "Percentage of new patients whose biopsy results have been reviewed and communicated to the primary care/referring physician and patient.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "American Academy of Dermatology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "dermatology", "obstetricsGynecology", "otolaryngology", "urology" ], "measureSpecification": {} }, { "title": "Epilepsy: Counseling for Women of Childbearing Potential with Epilepsy", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "268", "description": "Percentage of all patients of childbearing potential (12 years and older) diagnosed with epilepsy who were counseled at least once a year about how epilepsy and its treatment may affect contraception and pregnancy.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Academy of Neurology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "neurology" ], "measureSpecification": {} }, { "title": "Inflammatory Bowel Disease (IBD): Assessment of Hepatitis B Virus (HBV) Status Before Initiating Anti-TNF (Tumor Necrosis Factor) Therapy", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "275", "description": "Percentage of patients with a diagnosis of inflammatory bowel disease (IBD) who had Hepatitis B Virus (HBV) status assessed and results interpreted prior to initiating anti-TNF (tumor necrosis factor) therapy.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Gastroenterological Association", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "gastroenterology" ], "measureSpecification": {} }, { "title": "Sleep Apnea: Severity Assessment at Initial Diagnosis", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "277", "description": "Percentage of patients aged 18 years and older with a diagnosis of obstructive sleep apnea who had an apnea hypopnea index (AHI) or a respiratory disturbance index (RDI) measured at the time of initial diagnosis.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Academy of Sleep Medicine", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "internalMedicine", "neurology", "otolaryngology", "pulmonology" ], "measureSpecification": {} }, { "title": "Sleep Apnea: Assessment of Adherence to Positive Airway Pressure Therapy", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "279", "description": "Percentage of visits for patients aged 18 years and older with a diagnosis of obstructive sleep apnea who were prescribed positive airway pressure therapy who had documentation that adherence to positive airway pressure therapy was objectively measured.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Academy of Sleep Medicine", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "internalMedicine", "neurology", "otolaryngology", "pulmonology" ], "measureSpecification": {} }, { "title": "Dementia: Cognitive Assessment", "eMeasureId": "CMS149v10", "nqfEMeasureId": "2872e", "nqfId": null, "measureId": "281", "description": "Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Academy of Neurology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord" ], "measureSets": [ "clinicalSocialWork", "geriatrics", "mentalBehavioralHealth", "neurology", "physicalTherapyOccupationalTherapy" ], "measureSpecification": {} }, { "title": "Dementia: Functional Status Assessment", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "282", "description": "Percentage of patients with dementia for whom an assessment of functional status was performed at least once in the last 12 months.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Academy of Neurology/American Psychiatric Association", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "clinicalSocialWork", "geriatrics", "mentalBehavioralHealth", "neurology" ], "measureSpecification": {} }, { "title": "Dementia Associated Behavioral and Psychiatric Symptoms Screening and Management", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "283", "description": "Percentage of patients with dementia for whom there was a documented screening for behavioral and psychiatric symptoms, including depression, and for whom, if symptoms screening was positive, there was also documentation of recommendations for management in the last 12 months.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Academy of Neurology/American Psychiatric Association", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "clinicalSocialWork", "geriatrics", "mentalBehavioralHealth", "neurology", "physicalTherapyOccupationalTherapy" ], "measureSpecification": {} }, { "title": "Dementia: Safety Concern Screening and Follow-Up for Patients with Dementia", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "286", "description": "Percentage of patients with dementia or their caregiver(s) for whom there was a documented safety concerns screening in two domains of risk: 1) dangerousness to self or others and 2) environmental risks; and if safety concerns screening was positive in the last 12 months, there was documentation of mitigation recommendations, including but not limited to referral to other resources.", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "process", "isHighPriority": true, "primarySteward": "American Academy of Neurology/American Psychiatric Association", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "clinicalSocialWork", "geriatrics", "mentalBehavioralHealth", "neurology", "physicalTherapyOccupationalTherapy" ], "measureSpecification": {} }, { "title": "Dementia: Education and Support of Caregivers for Patients with Dementia", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "288", "description": "Percentage of patients with dementia whose caregiver(s) were provided with education on dementia disease management and health behavior changes AND were referred to additional resources for support in the last 12 months.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "American Academy of Neurology/American Psychiatric Association", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "clinicalSocialWork", "geriatrics", "mentalBehavioralHealth", "neurology", "physicalTherapyOccupationalTherapy" ], "measureSpecification": {} }, { "title": "Assessment of Mood Disorders and Psychosis for Patients with Parkinson's Disease", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "290", "description": "Percentage of all patients with a diagnosis of Parkinson's Disease [PD] who were assessed for depression, anxiety, apathy, AND psychosis once during the measurement period.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Academy of Neurology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "neurology" ], "measureSpecification": {} }, { "title": "Assessment of Cognitive Impairment or Dysfunction for Patients with Parkinson's Disease", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "291", "description": "Percentage of all patients with a diagnosis of Parkinson's Disease [PD] who were assessed for cognitive impairment or dysfunction once during the measurement period.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Academy of Neurology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "neurology" ], "measureSpecification": {} }, { "title": "Rehabilitative Therapy Referral for Patients with Parkinson's Disease", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "293", "description": "Percentage of all patients with a diagnosis of Parkinson's Disease who were referred to physical, occupational, speech, or recreational therapy once during the measurement period.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "American Academy of Neurology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "neurology" ], "measureSpecification": {} }, { "title": "Cataracts: Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "303", "description": "Percentage of patients aged 18 years and older who had cataract surgery and had improvement in visual function achieved within 90 days following the cataract surgery, based on completing a pre-operative and post-operative visual function survey.", "nationalQualityStrategyDomain": "Person and Caregiver-Centered Experience and Outcomes", "measureType": "patientReportedOutcome", "isHighPriority": true, "primarySteward": "American Academy of Ophthalmology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "ophthalmology" ], "measureSpecification": {} }, { "title": "Cataracts: Patient Satisfaction within 90 Days Following Cataract Surgery", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "304", "description": "Percentage of patients aged 18 years and older who had cataract surgery and were satisfied with their care within 90 days following the cataract surgery, based on completion of the Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey.", "nationalQualityStrategyDomain": "Person and Caregiver-Centered Experience and Outcomes", "measureType": "patientEngagementExperience", "isHighPriority": true, "primarySteward": "American Academy of Ophthalmology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "ophthalmology" ], "measureSpecification": {} }, { "title": "Initiation and Engagement of Alcohol and Other Drug Dependence Treatment", "eMeasureId": "CMS137v10", "nqfEMeasureId": null, "nqfId": null, "measureId": "305", "description": "Percentage of patients 13 years of age and older with a new episode of alcohol or other drug abuse or (AOD) dependence who received the following. Two rates are reported.a. Percentage of patients who initiated treatment including either an intervention or medication for the treatment of AOD abuse or dependence within 14 days of the diagnosis.b. Percentage of patients who engaged in ongoing treatment including two additional interventions or a medication for the treatment of AOD abuse or dependence within 34 days of the initiation visit. For patients who initiated treatment with a medication, at least one of the two engagement events must be a treatment intervention.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": true, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "overallAlgorithm": "simpleAverage", "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "multiPerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord" ], "measureSets": [ "familyMedicine", "internalMedicine", "pediatrics" ], "measureSpecification": {}, "strata": [ { "name": "14DaysOfDiagnosis", "description": "Patients who initiated treatment within 14 days of the diagnosis" }, { "name": "30DaysOfVisit", "description": "Patients who initiated treatment and who had two or more additional services with an AOD diagnosis within 30 days of the initiation visit" } ] }, { "title": "Cervical Cancer Screening", "eMeasureId": "CMS124v10", "nqfEMeasureId": null, "nqfId": null, "measureId": "309", "description": "Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria:* Women age 21-64 who had cervical cytology performed within the last 3 years* Women age 30-64 who had cervical human papillomavirus (HPV) testing performed within the last 5 years", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord" ], "measureSets": [ "familyMedicine", "internalMedicine", "obstetricsGynecology" ], "measureSpecification": {} }, { "title": "Chlamydia Screening for Women", "eMeasureId": "CMS153v10", "nqfEMeasureId": null, "nqfId": null, "measureId": "310", "description": "Percentage of women 16-24 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement period.", "nationalQualityStrategyDomain": "Community/Population Health", "measureType": "process", "isHighPriority": false, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord" ], "measureSets": [ "obstetricsGynecology", "pediatrics" ], "measureSpecification": {} }, { "title": "Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented", "eMeasureId": "CMS22v10", "nqfEMeasureId": null, "nqfId": null, "measureId": "317", "description": "Percentage of patient visits for patients aged 18 years and older seen during the measurement period who were screened for high blood pressure AND a recommended follow-up plan is documented, as indicated, if blood pressure is elevated or hypertensive.", "nationalQualityStrategyDomain": "Community/Population Health", "measureType": "process", "isHighPriority": false, "primarySteward": "Centers for Medicare & Medicaid Services", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "claims", "electronicHealthRecord", "registry" ], "measureSets": [ "allergyImmunology", "cardiology", "dermatology", "emergencyMedicine", "familyMedicine", "gastroenterology", "generalSurgery", "internalMedicine", "mentalBehavioralHealth", "nephrology", "neurology", "obstetricsGynecology", "oncology", "orthopedicSurgery", "otolaryngology", "physicalMedicine", "plasticSurgery", "preventiveMedicine", "rheumatology", "skilledNursingFacility", "urgentCare", "urology", "vascularSurgery" ], "measureSpecification": {} }, { "title": "Falls: Screening for Future Fall Risk", "eMeasureId": "CMS139v10", "nqfEMeasureId": null, "nqfId": "0101", "measureId": "318", "description": "Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period.", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "process", "isHighPriority": true, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord", "cmsWebInterface" ], "measureSets": [ "audiology", "familyMedicine", "internalMedicine", "nephrology", "orthopedicSurgery", "otolaryngology", "physicalTherapyOccupationalTherapy", "podiatry" ], "measureSpecification": {} }, { "title": "Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "0658", "measureId": "320", "description": "Percentage of patients aged 50 to 75 years of age receiving a screening colonoscopy without biopsy or polypectomy who had a recommended follow-up interval of at least 10 years for repeat colonoscopy documented in their colonoscopy report.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "American Gastroenterological Association", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "claims", "registry" ], "measureSets": [ "gastroenterology" ], "measureSpecification": {} }, { "title": "CAHPS for MIPS Clinician/Group Survey", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "0005", "measureId": "321", "description": "The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Clinician/Group Survey is comprised of 10 Summary Survey Measures (SSMs) and measures patient experience of care within a group practice. The NQF endorsement status and endorsement id (if applicable) for each SSM utilized in this measure are as follows: Getting Timely Care, Appointments, and Information; (Not endorsed by NQF) How well Providers Communicate; (Not endorsed by NQF) Patient's Rating of Provider; (NQF endorsed # 0005) Access to Specialists; (Not endorsed by NQF) Health Promotion and Education; (Not endorsed by NQF) Shared Decision-Making; (Not endorsed by NQF) Health Status and Functional Status; (Not endorsed by NQF) Courteous and Helpful Office Staff; (NQF endorsed # 0005) Care Coordination; (Not endorsed by NQF) Stewardship of Patient Resources. (Not endorsed by NQF)", "nationalQualityStrategyDomain": "Person and Caregiver-Centered Experience and Outcomes", "measureType": "patientEngagementExperience", "isHighPriority": true, "primarySteward": "Agency for Healthcare Research & Quality", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "cahps", "allowedPrograms": [ "mips", "pcf", "app1" ], "submissionMethods": [ "certifiedSurveyVendor" ], "measureSets": [ "familyMedicine", "internalMedicine" ], "measureSpecification": {} }, { "title": "Cardiac Stress Imaging Not Meeting Appropriate Use Criteria: Preoperative Evaluation in Low-Risk Surgery Patients", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "322", "description": "Percentage of stress single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), stress echocardiogram (ECHO), cardiac computed tomography angiography (CCTA), or cardiac magnetic resonance (CMR) performed in low-risk surgery patients 18 years or older for preoperative evaluation during the 12-month submission period.", "nationalQualityStrategyDomain": "Efficiency and Cost Reduction", "measureType": "efficiency", "isHighPriority": true, "primarySteward": "American College of Cardiology Foundation", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": true, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "cardiology" ], "measureSpecification": {} }, { "title": "Cardiac Stress Imaging Not Meeting Appropriate Use Criteria: Routine Testing After Percutaneous Coronary Intervention (PCI)", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "323", "description": "Percentage of all stress single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), stress echocardiogram (ECHO), cardiac computed tomography angiography (CCTA), and cardiovascular magnetic resonance (CMR) performed in patients aged 18 years and older routinely after percutaneous coronary intervention (PCI), with reference to timing of test after PCI and symptom status.", "nationalQualityStrategyDomain": "Efficiency and Cost Reduction", "measureType": "efficiency", "isHighPriority": true, "primarySteward": "American College of Cardiology Foundation", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": true, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "cardiology" ], "measureSpecification": {} }, { "title": "Cardiac Stress Imaging Not Meeting Appropriate Use Criteria: Testing in Asymptomatic, Low-Risk Patients", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "324", "description": "Percentage of all stress single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), stress echocardiogram (ECHO), cardiac computed tomography angiography (CCTA), and cardiovascular magnetic resonance (CMR) performed in asymptomatic, low coronary heart disease (CHD) risk patients 18 years and older for initial detection and risk assessment.", "nationalQualityStrategyDomain": "Efficiency and Cost Reduction", "measureType": "efficiency", "isHighPriority": true, "primarySteward": "American College of Cardiology Foundation", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": true, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "cardiology" ], "measureSpecification": {} }, { "title": "Atrial Fibrillation and Atrial Flutter: Chronic Anticoagulation Therapy", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "1525", "measureId": "326", "description": "Percentage of patients aged 18 years and older with atrial fibrillation (AF) or atrial flutter who were prescribed an FDA-approved oral anticoagulant drug for the prevention of thromboembolism during the measurement period.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Heart Association", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "cardiology", "familyMedicine", "internalMedicine", "skilledNursingFacility" ], "measureSpecification": {} }, { "title": "Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse)", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "331", "description": "Percentage of patients, aged 18 years and older, with a diagnosis of acute viral sinusitis who were prescribed an antibiotic within 10 days after onset of symptoms.", "nationalQualityStrategyDomain": "Efficiency and Cost Reduction", "measureType": "process", "isHighPriority": true, "primarySteward": "American Academy of Otolaryngology - Head and Neck Surgery Foundation", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": true, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "allergyImmunology", "emergencyMedicine", "familyMedicine", "internalMedicine", "otolaryngology", "urgentCare" ], "measureSpecification": {} }, { "title": "Adult Sinusitis: Appropriate Choice of Antibiotic: Amoxicillin With or Without Clavulanate Prescribed for Patients with Acute Bacterial Sinusitis (Appropriate Use)", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "332", "description": "Percentage of patients aged 18 years and older with a diagnosis of acute bacterial sinusitis that were prescribed amoxicillin, with or without clavulanate, as a first line antibiotic at the time of diagnosis.", "nationalQualityStrategyDomain": "Efficiency and Cost Reduction", "measureType": "process", "isHighPriority": true, "primarySteward": "American Academy of Otolaryngology - Head and Neck Surgery Foundation", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "allergyImmunology", "emergencyMedicine", "familyMedicine", "internalMedicine", "otolaryngology", "urgentCare" ], "measureSpecification": {} }, { "title": "Maternity Care: Elective Delivery (Without Medical Indication) at < 39 Weeks (Overuse)", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "335", "description": "Percentage of patients, regardless of age, who gave birth during a 12-month period, delivered a live singleton at < 39 weeks of gestation, and had elective deliveries (without medical indication) by cesarean birth or induction of labor.", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "outcome", "isHighPriority": true, "primarySteward": "Centers for Medicare & Medicaid Services", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": true, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "certifiedNurseMidwife", "obstetricsGynecology" ], "measureSpecification": {} }, { "title": "Maternity Care: Postpartum Follow-up and Care Coordination", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "336", "description": "Percentage of patients, regardless of age, who gave birth during a 12-month period who were seen for postpartum care before or at 12 weeks of giving birth and received the following at a postpartum visit: breast-feeding evaluation and education, postpartum depression screening, postpartum glucose screening for gestational diabetes patients, family and contraceptive planning counseling, tobacco use screening and cessation education, healthy lifestyle behavioral advice, and an immunization review and update.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "Centers for Medicare & Medicaid Services", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "certifiedNurseMidwife", "obstetricsGynecology" ], "measureSpecification": {} }, { "title": "HIV Viral Load Suppression", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "2082", "measureId": "338", "description": "The percentage of patients, regardless of age, with a diagnosis of HIV with a HIV viral load less than 200 copies/mL at last HIV viral load test during the measurement year.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "outcome", "isHighPriority": true, "primarySteward": "Health Resources and Services Administration", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "allergyImmunology", "familyMedicine", "infectiousDisease", "internalMedicine" ], "measureSpecification": {} }, { "title": "HIV Medical Visit Frequency", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "2079", "measureId": "340", "description": "Percentage of patients, regardless of age with a diagnosis of HIV who had at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits.", "nationalQualityStrategyDomain": "Efficiency and Cost Reduction", "measureType": "process", "isHighPriority": true, "primarySteward": "Health Resources and Services Administration", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "allergyImmunology", "infectiousDisease" ], "measureSpecification": {} }, { "title": "Rate of Carotid Artery Stenting (CAS) for Asymptomatic Patients, Without Major Complications (Discharged to Home by Post-Operative Day #2)", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "344", "description": "Percent of asymptomatic patients undergoing CAS who are discharged to home no later than post-operative day #2.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "outcome", "isHighPriority": true, "primarySteward": "Society for Vascular Surgeons", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "cardiology", "neurosurgical", "vascularSurgery" ], "measureSpecification": {} }, { "title": "Total Knee or Hip Replacement: Shared Decision-Making: Trial of Conservative (Non-surgical) Therapy", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "350", "description": "Percentage of patients regardless of age undergoing a total knee or total hip replacement with documented shared decision- making with discussion of conservative (non-surgical) therapy (e.g., non-steroidal anti-inflammatory drug (NSAIDs), analgesics, weight loss, exercise, injections) prior to the procedure.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "American Association of Hip and Knee Surgeons", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "orthopedicSurgery" ], "measureSpecification": {} }, { "title": "Total Knee or Hip Replacement: Venous Thromboembolic and Cardiovascular Risk Evaluation", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "351", "description": "Percentage of patients regardless of age undergoing a total knee or total hip replacement who are evaluated for the presence or absence of venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., History of Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE), Myocardial Infarction (MI), Arrhythmia and Stroke).", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "process", "isHighPriority": true, "primarySteward": "American Association of Hip and Knee Surgeons", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "orthopedicSurgery" ], "measureSpecification": {} }, { "title": "Anastomotic Leak Intervention", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "354", "description": "Percentage of patients aged 18 years and older who required an anastomotic leak intervention following gastric bypass or colectomy surgery.", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "outcome", "isHighPriority": true, "primarySteward": "American College of Surgeons", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": true, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "generalSurgery" ], "measureSpecification": {} }, { "title": "Unplanned Reoperation within the 30 Day Postoperative Period", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "355", "description": "Percentage of patients aged 18 years and older who had any unplanned reoperation within the 30 day postoperative period.", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "outcome", "isHighPriority": true, "primarySteward": "American College of Surgeons", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": true, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "generalSurgery", "plasticSurgery" ], "measureSpecification": {} }, { "title": "Unplanned Hospital Readmission within 30 Days of Principal Procedure", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "356", "description": "Percentage of patients aged 18 years and older who had an unplanned hospital readmission within 30 days of principal procedure.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "outcome", "isHighPriority": true, "primarySteward": "American College of Surgeons", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": true, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "generalSurgery", "plasticSurgery" ], "measureSpecification": {} }, { "title": "Surgical Site Infection (SSI)", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "357", "description": "Percentage of patients aged 18 years and older who had a surgical site infection (SSI).", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "outcome", "isHighPriority": true, "primarySteward": "American College of Surgeons", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": true, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "generalSurgery", "otolaryngology", "plasticSurgery", "vascularSurgery" ], "measureSpecification": {} }, { "title": "Patient-Centered Surgical Risk Assessment and Communication", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "358", "description": "Percentage of patients who underwent a non-emergency surgery who had their personalized risks of postoperative complications assessed by their surgical team prior to surgery using a clinical data-based, patient-specific risk calculator and who received personal discussion of those risks with the surgeon.", "nationalQualityStrategyDomain": "Person and Caregiver-Centered Experience and Outcomes", "measureType": "process", "isHighPriority": true, "primarySteward": "American College of Surgeons", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "generalSurgery", "orthopedicSurgery", "otolaryngology", "plasticSurgery", "thoracicSurgery", "urology", "vascularSurgery" ], "measureSpecification": {} }, { "title": "Optimizing Patient Exposure to Ionizing Radiation: Count of Potential High Dose Radiation Imaging Studies: Computed Tomography (CT) and Cardiac Nuclear Medicine Studies", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "360", "description": "Percentage of computed tomography (CT) and cardiac nuclear medicine (myocardial perfusion studies) imaging reports for all patients, regardless of age, that document a count of known previous CT (any type of CT) and cardiac nuclear medicine (myocardial perfusion) studies that the patient has received in the 12-month period prior to the current study.", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "process", "isHighPriority": true, "primarySteward": "American College of Radiology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "diagnosticRadiology" ], "measureSpecification": {} }, { "title": "Optimizing Patient Exposure to Ionizing Radiation: Appropriateness: Follow-up CT Imaging for Incidentally Detected Pulmonary Nodules According to Recommended Guidelines", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "364", "description": "Percentage of final reports for CT imaging studies with a finding of an incidental pulmonary nodule for patients aged 35 years and older that contain an impression or conclusion that includes a recommended interval and modality for follow-up (e.g., type of imaging or biopsy) or for no follow-up, and source of recommendations (e.g., guidelines such as Fleischner Society, American Lung Association, American College of Chest Physicians).", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "American College of Radiology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "diagnosticRadiology" ], "measureSpecification": {} }, { "title": "Follow-Up Care for Children Prescribed ADHD Medication (ADD)", "eMeasureId": "CMS136v11", "nqfEMeasureId": null, "nqfId": null, "measureId": "366", "description": "Percentage of children 6-12 years of age and newly dispensed a medication for attention-deficit/hyperactivity disorder (ADHD) who had appropriate follow-up care. Two rates are reported. a) Percentage of children who had one follow-up visit with a practitioner with prescribing authority during the 30-Day Initiation Phase.b) Percentage of children who remained on ADHD medication for at least 210 days and who, in addition to the visit in the Initiation Phase, had at least two additional follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase ended.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "overallAlgorithm": "overallStratumOnly", "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "multiPerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord" ], "measureSets": [ "mentalBehavioralHealth", "pediatrics" ], "measureSpecification": {}, "strata": [ { "name": "visitWithin30Days", "description": "Percentage of children who had one follow-up visit with a practitioner with prescribing authority during the 30-Day Initiation Phase." }, { "name": "overall", "description": "Percentage of children who remained on ADHD medication for at least 210 days and who, in addition to the visit in the Initiation Phase, had at least two additional follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase ended." } ] }, { "title": "Depression Remission at Twelve Months", "eMeasureId": "CMS159v10", "nqfEMeasureId": "0710e", "nqfId": "0710", "measureId": "370", "description": "The percentage of adolescent patients 12 to 17 years of age and adult patients 18 years of age or older with major depression or dysthymia who reached remission 12 months (+/- 60 days) after an index event date.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "outcome", "isHighPriority": true, "primarySteward": "Minnesota Community Measurement", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "overallAlgorithm": "weightedAverage", "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "multiPerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord", "cmsWebInterface", "registry" ], "measureSets": [ "clinicalSocialWork", "familyMedicine", "geriatrics", "internalMedicine", "mentalBehavioralHealth", "pediatrics" ], "measureSpecification": {}, "strata": [ { "name": "12-17yrs", "description": "Percentage of adolescent patients (aged 12-17 years) with a diagnosis of major depression or dysthymia and an\ninitial PHQ-9 or PHQ-9M score greater than nine during the index event who reached remission at twelve\nmonths as demonstrated by a twelve month (+/-60 days) PHQ-9 or PHQ-9M score of less than 5." }, { "name": "18+", "description": "Percentage of adult patients (aged 18 years or older) with a diagnosis of major depression or dysthymia and an\ninitial PHQ-9 or PHQ-9M score greater than nine during the index event who reached remission at twelve\nmonths as demonstrated by a twelve month (+/-60 days) PHQ-9 or PHQ-9M score of less than 5." } ] }, { "title": "Closing the Referral Loop: Receipt of Specialist Report", "eMeasureId": "CMS50v10", "nqfEMeasureId": null, "nqfId": null, "measureId": "374", "description": "Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "Centers for Medicare & Medicaid Services", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord", "registry" ], "measureSets": [ "allergyImmunology", "cardiology", "dermatology", "endocrinology", "familyMedicine", "gastroenterology", "generalSurgery", "internalMedicine", "interventionalRadiology", "neurology", "obstetricsGynecology", "oncology", "ophthalmology", "orthopedicSurgery", "otolaryngology", "physicalMedicine", "preventiveMedicine", "pulmonology", "rheumatology", "thoracicSurgery", "urology", "vascularSurgery" ], "measureSpecification": {} }, { "title": "Functional Status Assessment for Total Knee Replacement", "eMeasureId": "CMS66v10", "nqfEMeasureId": null, "nqfId": null, "measureId": "375", "description": "Percentage of patients 18 years of age and older who received an elective primary total knee arthroplasty (TKA) and completed a functional status assessment within 90 days prior to the surgery and in the 270-365 days after the surgery.", "nationalQualityStrategyDomain": "Person and Caregiver-Centered Experience and Outcomes", "measureType": "process", "isHighPriority": true, "primarySteward": "Centers for Medicare & Medicaid Services", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord" ], "measureSets": [ "orthopedicSurgery" ], "measureSpecification": {} }, { "title": "Functional Status 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"orthopedicSurgery" ], "measureSpecification": {} }, { "title": "Functional Status Assessments for Heart Failure", "eMeasureId": "CMS90v11", "nqfEMeasureId": null, "nqfId": null, "measureId": "377", "description": "Percentage of patients 18 years of age and older with heart failure who completed initial and follow-up patient-reported functional status assessments.", "nationalQualityStrategyDomain": "Person and Caregiver-Centered Experience and Outcomes", "measureType": "process", "isHighPriority": true, "primarySteward": "Centers for Medicare & Medicaid Services", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord" ], "measureSets": [ "familyMedicine", "internalMedicine" ], "measureSpecification": {} }, { "title": "Children Who Have Dental Decay or Cavities", "eMeasureId": "CMS75v10", "nqfEMeasureId": null, "nqfId": null, "measureId": "378", "description": "Percentage of children, 6 months - 20 years of age at the start of the measurement period, who have had tooth decay or cavities during the measurement period.", "nationalQualityStrategyDomain": "Community/Population Health", "measureType": "outcome", "isHighPriority": true, "primarySteward": "Centers for Medicare & Medicaid Services", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": true, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord" ], "measureSets": [ "dentistry" ], "measureSpecification": {} }, { "title": "Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists", "eMeasureId": "CMS74v11", "nqfEMeasureId": null, "nqfId": null, "measureId": "379", "description": "Percentage of children, 6 months - 20 years of age, who received a fluoride varnish application during the measurement period.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "Centers for Medicare & Medicaid Services", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord" ], "measureSets": [ "dentistry", "pediatrics" ], "measureSpecification": {} }, { "title": "Child and Adolescent Major Depressive Disorder (MDD): Suicide Risk Assessment", "eMeasureId": "CMS177v10", "nqfEMeasureId": "1365e", "nqfId": null, "measureId": "382", "description": "Percentage of patient visits for those patients aged 6 through 17 years with a diagnosis of major depressive disorder with an assessment for suicide risk.", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "process", "isHighPriority": true, "primarySteward": "Mathematica", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord" ], "measureSets": [ "clinicalSocialWork", "mentalBehavioralHealth", "pediatrics" ], "measureSpecification": {} }, { "title": "Adherence to Antipsychotic Medications For Individuals with Schizophrenia", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "1879", "measureId": "383", "description": "Percentage of individuals at least 18 years of age as of the beginning of the performance period with schizophrenia or schizoaffective disorder who had at least two prescriptions filled for any antipsychotic medication and who had a Proportion of Days Covered (PDC) of at least 0.8 for antipsychotic medications during the performance period.", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "intermediateOutcome", "isHighPriority": true, "primarySteward": "Centers for Medicare & Medicaid Services", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "clinicalSocialWork", "familyMedicine", "internalMedicine", "mentalBehavioralHealth" ], "measureSpecification": {} }, { "title": "Adult Primary Rhegmatogenous Retinal Detachment Surgery: No Return to the Operating Room Within 90 Days of Surgery", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "384", "description": "Patients aged 18 years and older who had surgery for primary rhegmatogenous retinal detachment who did not require a return to the operating room within 90 days of surgery.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "outcome", "isHighPriority": true, "primarySteward": "American Academy of Ophthalmology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "ophthalmology" ], "measureSpecification": {} }, { "title": "Adult Primary Rhegmatogenous Retinal Detachment Surgery: Visual Acuity Improvement Within 90 Days of Surgery", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "385", "description": "Patients aged 18 years and older who had surgery for primary rhegmatogenous retinal detachment and achieved an improvement in their visual acuity, from their preoperative level, within 90 days of surgery in the operative eye.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "outcome", "isHighPriority": true, "primarySteward": "American Academy of Ophthalmology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "ophthalmology" ], "measureSpecification": {} }, { "title": "Amyotrophic Lateral Sclerosis (ALS) Patient Care Preferences", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "386", "description": "Percentage of patients diagnosed with Amyotrophic Lateral Sclerosis (ALS) who were offered assistance in planning for end of life issues (e.g., advance directives, invasive ventilation, hospice) at least once annually.", "nationalQualityStrategyDomain": "Person and Caregiver-Centered Experience and Outcomes", "measureType": "process", "isHighPriority": true, "primarySteward": "American Academy of Neurology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "neurology" ], "measureSpecification": {} }, { "title": "Annual Hepatitis C Virus (HCV) Screening for Patients who are Active Injection Drug Users", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "387", "description": "Percentage of patients, regardless of age, who are active injection drug users who received screening for HCV infection within the 12-month reporting period.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Gastroenterological Association", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "familyMedicine", "internalMedicine" ], "measureSpecification": {} }, { "title": "Cataract Surgery: Difference Between Planned and Final Refraction", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "389", "description": "Percentage of patients aged 18 years and older who had cataract surgery performed and who achieved a final refraction within +/- 1.0 diopters of their planned (target) refraction.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "outcome", "isHighPriority": true, "primarySteward": "American Academy of Ophthalmology", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "ophthalmology" ], "measureSpecification": {} }, { "title": "Follow-Up After Hospitalization for Mental Illness (FUH)", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "0576", "measureId": "391", "description": "The percentage of discharges for patients 6 years of age and older who were hospitalized for treatment of selected mental illness or intentional self-harm diagnoses and who had a follow-up visit with a mental health provider. Two rates are submitted: The percentage of discharges for which the patient received follow-up within 30 days after discharge The percentage of discharges for which the patient received follow-up within 7 days after discharge", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "overallAlgorithm": "overallStratumOnly", "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "multiPerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "internalMedicine", "mentalBehavioralHealth", "pediatrics" ], "measureSpecification": {}, "strata": [ { "name": "30days", "description": "The percentage of discharges for which the patient received follow-up within 30 days after discharge" }, { "name": "overall", "description": "The percentage of discharges for which the patient received follow-up within 7 days after discharge" } ] }, { "title": "Cardiac Tamponade and/or Pericardiocentesis Following Atrial Fibrillation Ablation", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "2474", "measureId": "392", "description": "Rate of cardiac tamponade and/or pericardiocentesis following atrial fibrillation ablation. This measure is submitted as four rates stratified by age and gender: Submission Age Criteria 1: Females 18-64 years of age Submission Age Criteria 2: Males 18-64 years of age Submission Age Criteria 3: Females 65 years of age and older Submission Age Criteria 4: Males 65 years of age and older", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "outcome", "isHighPriority": true, "primarySteward": "American College of Cardiology Foundation", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": true, "overallAlgorithm": "overallStratumOnly", "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "multiPerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "electrophysiologyCardiacSpecialist" ], "measureSpecification": {}, "strata": [ { "name": "18-64F", "description": "Females 18-64 years of age" }, { "name": "18-64M", "description": "Males 18-64 years of age" }, { "name": "65+F", "description": "Females 65 years of age and older" }, { "name": "65+M", "description": "Males 65 years of age and older" }, { "name": "overall", "description": "Overall percentage of patients with cardiac tamponade and/or pericardiocentesis occurring within 30 days" } ] }, { "title": "Infection within 180 Days of Cardiac Implantable Electronic Device (CIED) Implantation, Replacement, or Revision", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "393", "description": "Infection rate following CIED device implantation, replacement, or revision.", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "outcome", "isHighPriority": true, "primarySteward": "American College of Cardiology Foundation", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": true, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "electrophysiologyCardiacSpecialist" ], "measureSpecification": {} }, { "title": "Immunizations for Adolescents", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "394", "description": "The percentage of adolescents 13 years of age who had one dose of meningococcal vaccine (serogroups A, C, W, Y), one tetanus, diphtheria toxoids and acellular pertussis (Tdap) vaccine, and have completed the human papillomavirus (HPV) vaccine series by their 13th birthday.", "nationalQualityStrategyDomain": "Community/Population Health", "measureType": "process", "isHighPriority": false, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "overallAlgorithm": "overallStratumOnly", "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "multiPerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "familyMedicine", "pediatrics" ], "measureSpecification": {}, "strata": [ { "name": "meningococcal", "description": "Patients who had one dose of meningococcal vaccine on or between the patient's 11th and 13th birthdays" }, { "name": "Tdap", "description": "Patients who had one tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap) on or between the patient's 10th and 13th birthdays" }, { "name": "HPV", "description": "Patients who have completed the HPV vaccine with defferent dates of service on or between the patient's 9th and 13th birthdays" }, { "name": "overall", "description": "All patients who are compliant for Meningococcal, Tdap and HPV during the specified timeframes" } ] }, { "title": "Lung Cancer Reporting (Biopsy/Cytology Specimens)", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "395", "description": "Pathology reports based on lung biopsy and/or cytology specimens with a diagnosis of primary non-small cell lung cancer classified into specific histologic type following the International Association for the Study of Lung Cancer (IASLC) guidance or classified as non-small cell lung cancer not otherwise specified (NSCLC-NOS) with an explanation included in the pathology report.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "College of American Pathologists", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "claims", "registry" ], "measureSets": [ "pathology" ], "measureSpecification": {} }, { "title": "Lung Cancer Reporting (Resection Specimens)", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "396", "description": "Pathology reports based on lung resection specimens with a diagnosis of primary lung carcinoma that include the pT category, pN category and for non-small cell lung cancer (NSCLC), histologic type.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "College of American Pathologists", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "claims", "registry" ], "measureSets": [ "pathology" ], "measureSpecification": {} }, { "title": "Melanoma Reporting", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "397", "description": "Pathology reports for primary malignant cutaneous melanoma that include the pT category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "process", "isHighPriority": true, "primarySteward": "College of American Pathologists", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "claims", "registry" ], "measureSets": [ "pathology" ], "measureSpecification": {} }, { "title": "Optimal Asthma Control", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "398", "description": "Composite measure of the percentage of pediatric and adult patients whose asthma is well-controlled as demonstrated by one of three age appropriate patient reported outcome tools and not at risk for exacerbation.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "outcome", "isHighPriority": true, "primarySteward": "Minnesota Community Measurement", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "overallAlgorithm": "overallStratumOnly", "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "multiPerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "allergyImmunology", "familyMedicine", "internalMedicine", "otolaryngology", "pediatrics", "pulmonology" ], "measureSpecification": {}, "strata": [ { "name": "overall", "description": "Overall Percentage for patients (aged 5-50 years) with well-controlled asthma, without elevated risk of exacerbation" }, { "name": "5-17yrs", "description": "Percentage of pediatric patients (aged 5-17 years) with well-controlled asthma, without elevated risk of exacerbation." }, { "name": "18-50", "description": "Percentage of adult patients (aged 18-50 years) with well-controlled asthma, without elevated risk of exacerbation" }, { "name": "ACT5-17", "description": "Asthma well-controlled (submit the most recent specified asthma control tool result) for patients 5 to 17 with Asthma" }, { "name": "ACT18-50", "description": "Asthma 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"isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "familyMedicine", "internalMedicine", "nephrology" ], "measureSpecification": {} }, { "title": "Hepatitis C: Screening for Hepatocellular Carcinoma (HCC) in Patients with Cirrhosis", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "401", "description": "Percentage of patients aged 18 years and older with a diagnosis of chronic hepatitis C cirrhosis who underwent imaging with either ultrasound, contrast enhanced CT or MRI for hepatocellular carcinoma (HCC) at least once within the 12-month submission period.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": false, "primarySteward": "American Gastroenterological Association", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "familyMedicine", "gastroenterology", "internalMedicine" ], "measureSpecification": {} }, { "title": "Tobacco Use and Help with Quitting Among Adolescents", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "402", "description": "The percentage of adolescents 12 to 20 years of age with a primary care visit during the measurement year for whom tobacco use status was documented and received help with quitting if identified as a tobacco user.", "nationalQualityStrategyDomain": "Community/Population Health", "measureType": "process", "isHighPriority": false, "primarySteward": "National Committee for Quality Assurance", "firstPerformanceYear": 2017, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "allergyImmunology", "cardiology", "clinicalSocialWork", "dermatology", "familyMedicine", "gastroenterology", "generalSurgery", "internalMedicine", "mentalBehavioralHealth", "neurology", "obstetricsGynecology", "oncology", "orthopedicSurgery", "otolaryngology", "pediatrics", "physicalMedicine", "preventiveMedicine", "rheumatology", "thoracicSurgery", "urgentCare", "vascularSurgery" ], "measureSpecification": {} }, { "title": "Anesthesiology Smoking Abstinence", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "404", "description": "The percentage of current smokers who 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The measure is available as a computer adaptive test, for reduced patient burden, or a short form (static/paper-pencil).", "nationalQualityStrategyDomain": "Person and Caregiver-centered Experience and Outcomes", "measureType": "patientReportedOutcome", "isHighPriority": true, "primarySteward": "Focus on Therapeutic Outcomes, Inc.", "firstPerformanceYear": 2020, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "chiropracticMedicine", "orthopedicSurgery", "physicalTherapyOccupationalTherapy" ], "measureSpecification": {} }, { "title": "Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for the Merit-Based Incentive Payment System (MIPS) Groups", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "479", "description": "This measure is a re-specified version of the measure, \"Risk-adjusted readmission rate (RARR) of unplanned readmission within 30 days of hospital discharge for any condition\" (NQF 1789), which was developed for patients 65 years and older using Medicare claims. This re-specified measure attributes outcomes to MIPS participating clinician groups and assesses each group's readmission rate. The measure comprises a single summary score, derived from the results of five models, one for each of the following specialty cohorts (groups of discharge condition categories or procedure categories): medicine, surgery/gynecology, cardio-respiratory, cardiovascular, and neurology.", "nationalQualityStrategyDomain": "Communication and Care Coordination", "measureType": "outcome", "isHighPriority": true, "primarySteward": "Centers for Medicare & Medicaid Services", "firstPerformanceYear": 2021, "lastPerformanceYear": null, "isInverse": true, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "costScore", "allowedPrograms": [ "mips", "pcf", "app1" ], "submissionMethods": [ "administrativeClaims" ], "measureSets": [], "measureSpecification": {} }, { "title": "Risk-standardized complication rate (RSCR) following elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA) for Merit-based Incentive Payment System (MIPS)", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "3493", "measureId": "480", "description": "This measure is a re-specified version of the measure, \"Hospital-level Risk-standardized Complication rate (RSCR) following Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA)\" (National Quality Forum 1550), which was developed for patients 65 years and older using Medicare claims. This re-specified measure attributes outcomes to Merit-based Incentive Payment System participating clinicians and/or clinician groups (\"provider\") and assesses each provider's complication rate, defined as any one of the specified complications occurring from the date of index admission to up to 90 days post date of the index procedure.", "nationalQualityStrategyDomain": "Patient Safety", "measureType": "outcome", "isHighPriority": true, "primarySteward": "Centers for Medicare & Medicaid Services", "firstPerformanceYear": 2021, "lastPerformanceYear": null, "isInverse": true, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "costScore", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "administrativeClaims" ], "measureSets": [], "measureSpecification": {} }, { "title": "Intravesical Bacillus-Calmette Guerin for Non-muscle Invasive Bladder Cancer", "eMeasureId": "CMS646v2", "nqfEMeasureId": null, "nqfId": null, "measureId": "481", "description": "Percentage of patients initially diagnosed with non-muscle invasive bladder cancer and who received intravesical Bacillus-Calmette-Guerin (BCG) within 6 months of bladder cancer staging.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "process", "isHighPriority": true, "primarySteward": "Oregon Urology", "firstPerformanceYear": 2022, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "electronicHealthRecord" ], "measureSets": [ "urology" ], "measureSpecification": {} }, { "title": "Hemodialysis Vascular Access: Practitioner Level Long-term Catheter Rate", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "482", "description": "Percentage of adult hemodialysis patient-months using a catheter continuously for three months or longer for vascular access attributable to an individual practitioner or group practice.", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "intermediateOutcome", "isHighPriority": true, "primarySteward": "Centers for Medicare & Medicaid Services", "firstPerformanceYear": 2022, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "nephrology" ], "measureSpecification": {} }, { "title": "Person-Centered Primary Care Measure Patient Reported Outcome Performance Measure (PCPCM PRO-PM)", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": "3568", "measureId": "483", "description": "The Person-Centered Primary Care Measure Patient Reported Outcome Performance Measure (PCPCM PRO-PM) uses the PCPCM PROM (a comprehensive and parsimonious set of 11 patient-reported items) to assess the broad scope of primary care. Unlike other primary care measures, the PCPCM PRO-PM measures the high value aspects of primary care based on a patient's relationship with the clinician or practice. Patients identify the PCPCM PROM as meaningful and able to communicate the quality of their care to their clinicians and/or care team. The items within the PCPCM PROM are based on extensive stakeholder engagement and comprehensive reviews of the literature.", "nationalQualityStrategyDomain": "Person and Caregiver-centered Experience and Outcomes", "measureType": "patientReportedOutcome", "isHighPriority": true, "primarySteward": "The American Board of Family Medicine", "firstPerformanceYear": 2022, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "singlePerformanceRate", "allowedPrograms": [ "mips", "pcf" ], "submissionMethods": [ "registry" ], "measureSets": [ "familyMedicine", "internalMedicine" ], "measureSpecification": {} }, { "title": "Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions", "eMeasureId": null, "nqfEMeasureId": null, "nqfId": null, "measureId": "484", "description": "Annual risk-standardized rate of acute, unplanned hospital admissions among Medicare Fee-for-Service (FFS) patients aged 65 years and older with multiple chronic conditions (MCCs).", "nationalQualityStrategyDomain": "Effective Clinical Care", "measureType": "outcome", "isHighPriority": true, "primarySteward": "Centers for Medicare & Medicaid Services", "firstPerformanceYear": 2022, "lastPerformanceYear": null, "isInverse": false, "category": "quality", "isRegistryMeasure": false, "isRiskAdjusted": false, "icdImpacted": [], "isClinicalGuidelineChanged": false, "isIcdImpacted": false, "clinicalGuidelineChanged": [], "metricType": "costScore", "allowedPrograms": [ "mips", "pcf", "app1" ], "submissionMethods": [ "administrativeClaims" ], "measureSets": [], "measureSpecification": {} } ]