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Years 1 -3 Specifications- Clinical conditions and measures for
reporting and incentives (Year 1 - 3)

The CMS/Premier quality measures are based on clinical evidence and industry recognized metrics. For example, they include:

Measure revisions

Clinical conditions and measures

Clinical measure algorithm flowcharts by Focus Area
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The following files are zipped versions of all measures, see below for individual conditions.

v8 = Version 8: Discharges after July 1, 2006 (.zip)

v7 = Version 7: Discharges after April 1, 2006 (.zip)

v6 = Version 6: Discharges after January 1, 2006 (.zip)

v5 = Version 5: Discharges after October 1, 2005 (.zip)

v4 = Version 4: Discharges after July 1, 2005 (.zip)

v3= Version 3: Discharges after January 1, 2005 (.zip)

v2 = Version 2: Discharges after July 1, 2004 (.zip)

v1 = Version 1: Discharges before July 1, 2004 (.zip)

Current version is linked with each measure's name.  If older version exists, it will be linked to the right of the measure's name. If no version 2 is listed, there was no change from version 1 for that measure. 

Clinical conditions Measures
Acute myocardial infarction (AMI)

1. Aspirin at arrival(v8) (older version: v1, v3, v4, v5, v6, v7)

2. Aspirin prescribed at discharge(v8)
(older version:  v1, v3, v4, v5, v6, v7)

3. ACEI for LVSD(v8) (older version: v1, v3, v4, v5, v6, v7)

4. Smoking cessation advice/counseling(v8)
(older version: v1, v3, v4, v5, v6, v7)

5. Beta blocker prescribed at discharge(v8)
(older version: v1, v3, v4, v5, v6, v7)

6. Beta blocker at arrival(v8)
(older version: v1, v3, v4, v5,v6, v7)

7. Thrombolytic received within 30 minutes of hospital arriva(v8) (older version: v1, v2, v3, v4, v5, v6, v7)

8. PCI received within 120 minutes of hospital arrival(v8) (older version: v1, v2, v3, v4, v5, v6, v7)

9. Inpatient mortality rate(v8)
(older version: v1, v3, v4, v5, v6, v7)
Coronary artery bypass graft (CABG)

10. Aspirin prescribed at discharge(v7) (older version: v1, v3, v4, v5, v6)

11. CABG using internal mammary artery(v7) (older version: v1, v3, v4, v5, v6)

12. Prophylactic antibiotic received within one hour prior to surgical incision(v7) (older version: v1, v2, v3, v4, v5, v6)

13a. Prophylactic antibiotic selection for surgical patients(v8) (older version: v1, v2, v3, v4, v5, v6, v7)

14. Prophylactic antibiotics discontinued within 24 hours after surgery end time(v8)(older version: v1, v2, v3, v4, v5, v6, v7)

15. Inpatient mortality rate(v7)(older version: v1, v3, v4, v5, v6)

16. Post operative hemorrhage or hematoma(v6) (older version: v1, v3, v4, v5,)

17. Post operative physiologic and metabolic derangement(v6) (older version: v1, v3, v4, v5,)
Heart failure (HF)

18. Left Ventricular Systolic (LVS) assessment(v8) (older version: v1, v3, v4, v5, v6, v7)

19. Detailed discharge instructions(v8)
(older version: v1, v3, v4, v5, v6, v7)

20. ACEI or ARB for LVSD(v8)
(older version: v1, v3, v4, v5, v6, v7)

21. Smoking cessation advice/counseling(v8)
(older version: v1, v3, v4, v5, v6, v7)

Community-acquired pneumonia (CAP)

22. Percentage of patients who received an oxygenation assessment within 24 hours prior to or after hospital arrival(v8)
(older version:  v1, v2, v3, v4, v5, v6, v7)

23. Initial antibiotic selection (v8)
(older version:  v6, v7)

23a. Initial antibiotic consistent with current recommendations - ICU (v8-a)
(older version:  v1, v2, v3-a, v4-a, v5-a, v6-a, v7-a)

23b. Initial antibiotic consistent with current recommendations - Non ICU (v8-b)
(older version:  v1, v2, v3-b, v4-b, v5-b, v6-b, v7-b)

24. Blood culture collected prior to first antibiotic administration(v8)
(older version:  v1, v2, v3, v4, v5, v6, v7)

25. Influenza screening/vaccination(v8)
(older version:  v1, v2, v3, v4, v5, v6, v7)

26. Pneumococcal screening/vaccination(v8)
(older version: v1, v2,  v3, v4, v5,v6, v7)

27. Antibiotic timing, percentage of pneumonia patients who received first dose of antibiotics within four hours after hospital arrival(v8) (older version:  v1, v2, v3, v4, v5, v6, v7)

28. Smoking cessation advice/counseling(v8) (older version:  v1, v2, v3, v4, v5, v6, v7)
Hip and knee replacement9

29. Prophylactic antibiotic received within one hour prior to surgical incision(v8) (older version: v1, v2, v3, v4, v5, v6, v7)

30. Prophylactic antibiotic selection for surgical patients(v8) (older version: v1, v2, v3, v4, v5, v6, v7)

31. Prophylactic antibiotics discontinued within 24 hours after surgery end time(v8)(older version: v1, v2, v3, v4, v5, v6, v7)

32. Post operative hemorrhage or hematoma(v6) (older version: v1, v3, v4, v5)

33. Post operative physiologic and metabolic derangement(v6) (older version: v1, v3, v4, v5)

34. Readmissions 30 days post discharge(v7) (older version: v1, v3, v4, v5, v6, v7)

 

v8= Version 8: Discharges after July 1, 2006

Flowchart appendices v8 (.zip file): Includes ICD-9-CM codes, risk factor definitions, and medication tables.

v7= Version 7: Discharges after April 1, 2006

Flowchart appendices v7 (.zip file): Includes ICD-9-CM codes, risk factor definitions, and medication tables.

v6= Version 6: Discharges after January 1, 2006

Flowchart appendices v6 (.zip file): Includes ICD-9-CM codes, risk factor definitions, and medication tables.

v5= Version 5: Discharges after October 1, 2005

Flowchart appendices v5 (.zip file): Includes ICD-9-CM codes, risk factor definitions, and medication tables.

v4= Version 4: Discharges after July 1, 2005

Flowchart appendices v4 (.zip file): Includes ICD-9-CM codes, risk factor definitions, and medication tables.

v3= Version 3: Discharges after January 1, 2005

Flowchart appendices v3 (.zip file): Includes ICD-9-CM codes, risk factor definitions, and medication tables.

v2 = Version 2: Discharges after July 1, 2004

Flowchart appendices v2 (.zip file): Includes ICD-9-CM codes, risk factor definitions, and medication tables.

v1 = Version 1: Discharges before July 1, 2004

Flowchart appendices v1 (.zip file): Includes ICD-9-CM codes, risk factor definitions, and medication tables.

 

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