Have you heard of the elusive 7th measure and wondered if it would be applicable to you? How do you report it? Does it have any different requirements?
We got some answers for you.
The 30-Day All Cause Hospital Readmission Measure aka ACR aka 7th Measure is -
A risk-standardized readmission rate for beneficiaries age 65 or older who were hospitalized at a short-stay acute care hospital and experienced an unplanned readmission for any cause to an acute care hospital within 30 days of discharge.
This measure is applicable to only the groups of 16 or more clinicians. So if you are reporting as an Individual or are a group of less than 16 clinicians, this measure doesn’t apply to you. You would need to report only 6 quality measures for Quality Performance Category (unless your specialty set has less than 6 measures).
For the groups the Readmission Measure (ACR) is applicable, the good news is that this measure doesn’t need to be reported at all. CMS will calculate it from the Administrative Claims data for your group.
Unlike the case minimum for other quality measures, the minimum case volume for the Readmission Measure (ACR) is 200. If there are less than 200 cases for your group that satisfy the denominator criteria for ACR, it will not be scored for your group. Which means that your group score will be calculated out of 60 points or 110 points (if you are submitting quality measures data via CMS Web Interface).
The same scoring deciles and floor of 3 points that are applicable in transition year 2017 are applicable to the Readmission measure as well. So if your group meets the applicability and Case Minimum criteria, you will score a minimum of 3 points for this measure. However, it is important to note that CMS will only calculate and score the Readmission Measure if your group has submitted data for the other two performance categories – Advancing Care Information (ACI) and Improvement Activities (IA). This scoring policy seems pretty fair. The reporting groups get the credit while non-reporting groups don’t get out of penalty scot-free.
Although CMS has not released the benchmarks for this measure yet, it would be safe to assume that this is going to be an Inverse Measure. The lower the number, the better it is.
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