Others titles
- Historical Benchmarks for Consumer Assessment of Healthcare Providers
- Historical Benchmarks for the All Cause Hospital Readmission Measure
Keywords
- Quality Measures
- Quality Performance Benchmarks
- Quality Enhancement
Quality Measure Benchmarks
This dataset includes an overview of quality measure benchmarks, which is the result of the Medicare Access and CHIP Reauthorization Act (MACRA). The healthcare industry has been introduced to the Merit-Based Payment System (MIPS), which is expected to make changes to overall clinical quality measures. MIPS replaces the sustainable growth rate (SGR) formula by reassessing hospital and provider quality. Each benchmark is presented in terms of deciles.
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Description
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, which threatened clinicians participating in Medicare with potential payment cliffs for 13 years. If health providers participate in Medicare Part B, they are part of the dedicated team of clinicians who serve more than 55 million of the country’s most vulnerable Americans, and the Quality Payment Program will provide new tools and resources to help them give their patients the best possible care. They can choose how they want to participate based on their practice size, specialty, location, or patient population.
The Quality Payment Program has two tracks that can be chosen:
Advanced Alternative Payment Models (APMs) or
The Merit-based Incentive Payment System (MIPS)
If health providers decide to participate in an Advanced APM, through Medicare Part B they may earn an incentive payment for participating in an innovative payment model.
About this Dataset
Data Info
Date Created | 2016-12-29 |
---|---|
Last Modified | 2021-06-28 |
Version | 2021-06-11 |
Update Frequency |
Annual |
Temporal Coverage |
N/A |
Spatial Coverage |
United States |
Source | John Snow Labs; Centers for Medicare and Medicaid Services; |
Source License URL | |
Source License Requirements |
N/A |
Source Citation |
N/A |
Keywords | Quality Measures, Quality Performance Benchmarks, Quality Enhancement |
Other Titles | Historical Benchmarks for Consumer Assessment of Healthcare Providers, Historical Benchmarks for the All Cause Hospital Readmission Measure |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
Measure_Name | Measure Name for Quality Benchmarks | string | - |
Measure_ID | Measure Identification Number | string | - |
Submission_Method | Benchmark Group Type (EHR - Electronic Health Record, QCDR (Qualified Clinical Data Registry), claims) | string | - |
Measure_Type | Measure Type (e.g., outcome, process) | string | - |
Is_Benchmark | Indicates whether or not a measure is included in the benchmark analysis. True, the measure is included in benchmark analysis. False, the measure is not included in benchmark analysis. | boolean | - |
Decile_3 | The lower and upper bound of decile 3 data range (3-3.9 points the clinician earns for that measure) | string | - |
Decile_4 | The lower and upper bound of decile 4 data range (4-4.9 points the clinician earns for that measure) | string | - |
Decile_5 | The lower and upper bound of decile 5 data range (5-5.9 points the clinician earns for that measure) | string | - |
Decile_6 | The lower and upper bound of decile 6 data range (6-6.9 points the clinician earns for that measure) | string | - |
Decile_7 | The lower and upper bound of decile 7 data range (7-7.9 points the clinician earns for that measure) | string | - |
Decile_8 | The lower and upper bound of decile 8 data range (8-8.9 points the clinician earns for that measure) | string | - |
Decile_9 | The lower and upper bound of decile 9 data range (9-9.9 points the clinician earns for that measure) | string | - |
Decile_10 | The lower and upper bound of decile 10 data range (10 points the clinician earns for that measure) | string | - |
Is_Topped_Out | Indicates whether or not a measure is topped out. True, the measure is topped out. False, the measure is not topped out (topped out means the measure is not showing much variability and may have different scoring in future years) | boolean | - |
Is_Seven_Point_Cap_PY20 | Indicates whether or not a Topped Out Measure will receive special scoring. True, the measure is capped. False, the measure is not capped. | boolean | - |
Data Preview
Measure Name | Measure ID | Submission Method | Measure Type | Is Benchmark | Decile 3 | Decile 4 | Decile 5 | Decile 6 | Decile 7 | Decile 8 | Decile 9 | Decile 10 | Is Topped Out | Is Seven Point Cap PY20 |
30 Day All Cause Readmit Rate for Discharged Inpatients | HCPR19 | QCDR Measure | Outcome | True | False | |||||||||
ABCDEF Bundle - Early mobility for ICU patients | ACQR12 | QCDR Measure | Process | True | False | |||||||||
Abdominal Wall Reconstruction Surgical Site Occurrence Requiring Procedural Intervention within the 30 Day Postoperative Period | AHSQC6 | QCDR Measure | Outcome | True | False | |||||||||
Accurate Human Epidermal Growth Factor Receptor 2 (HER2) Tumor Evaluation and Repeat Evaluation in Patients with Breast Carcinoma | CAP11 | QCDR Measure | Process | True | False | |||||||||
Accurate Human Epidermal Growth Factor Receptor 2 (HER2) Tumor Evaluation and Repeat Evaluation in Patients with Gastroesophageal Adenocarcinoma | CAP12 | QCDR Measure | Process | True | False | |||||||||
Achievement of Projected Effective Dose of Standardized Allergens for Patient Treated With Allergen Immunotherapy for at Least One Year | AAAAI8 | QCDR Measure | Outcome | True | False | |||||||||
Acquired Involutional Entropion: Normalized lid position after surgical repair | IRIS6 | QCDR Measure | Outcome | True | False | |||||||||
Activity counseling for back pain | AAN26 | QCDR Measure | Process | False | False | |||||||||
Acute Anterior Uveitis: Post-treatment Grade 0 anterior chamber cells | IRIS17 | QCDR Measure | Outcome | True | 58.17100000000001 | 3.31 - 19.22 | 19.23 - 42.34 | 42.35 - 63.32 | 63.33 - 78.08 | 78.09 - 88.96 | 88.97 - 94.19 | False | ||
Acute Anterior Uveitis: Post-treatment visual acuity | IRIS51 | QCDR Measure | Outcome | True | False |