Measure: CMS90
Functional Status Assessments for Heart Failure
Measure Versions
| eMeasure Code |
Measure Year |
Full Version Number |
Title |
| CMS90v13 |
2024 |
13.0.000 |
Functional Status Assessments for Heart Failure |
| CMS90v12 |
2023 |
12 |
Functional Status Assessments for Heart Failure |
| CMS90v11 |
2022 |
11.1.000 |
Functional Status Assessments for Heart Failure |
| CMS90v10 |
2021 |
10.2.000 |
Functional Status Assessments for Congestive Heart Failure |
| CMS90v9 |
2020 |
9.1.000 |
Functional Status Assessments for Congestive Heart Failure |
| CMS90v8 |
2019 |
8.3.000 |
Functional Status Assessments for Congestive Heart Failure |
| CMS90v7 |
2018 |
7.1.000 |
Functional Status Assessments for Congestive Heart Failure |
| CMS90v6 |
2017 |
6.2.000 |
Functional Status Assessments for Congestive Heart Failure |
Description
Percentage of patients 18 years of age and older with heart failure who completed initial and follow-up patient-reported functional status assessments
Guidance
Initial functional status assessment (FSA) and encounter: The initial FSA is an FSA that occurs two weeks before or during an encounter, in the 180 days or more before the end of the measurement period.
Follow-up FSA: The follow-up FSA must be completed at least 30 days but no more than 180 days after the initial FSA.
The same FSA instrument must be used for the initial and follow-up assessment.
This eCQM is a patient-based measure.
This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM.
Patient Group Definitions
| Group |
Description |
Instructions Links |
| Initial Population | Patients 18 years of age and older who had two outpatient encounters during the measurement period and a diagnosis of heart failure that starts before and continues into the measurement period. | Webchart Instructions |
| Denominator | Equals Initial Population | Webchart Instructions |
| Denominator Exclusions | Exclude patients with severe cognitive impairment in any part of the measurement period.
Exclude patients who are in hospice care for any part of the measurement period. | Webchart Instructions |
| Numerator | Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12]; VR-36; Kansas City Cardiomyopathy Questionnaire [KCCQ]; KCCQ-12; Minnesota Living with Heart Failure Questionnaire [MLHFQ]; Patient-Reported Outcomes Measurement Information System [PROMIS]-10 Global Health, PROMIS-29) present in the EHR two weeks before or during the initial FSA encounter and results for the follow-up FSA at least 30 days but no more than 180 days after the initial FSA | Webchart Instructions |
| Numerator Exclusions | Not Applicable | Webchart Instructions |
| Denominator Exceptions | None | |
Details
| Full eMeasure Code |
eMeasure Identifier |
Measure Year |
Version |
NQF # |
GUID |
| CMS90v11 |
|
2022 |
11.1.000 |
Not Applicable |
bb9b8ef7-0354-40e0-bec7-d6891b7df519 |
| Steward |
Developer |
Endorsed By |
| National Committee for Quality Assurance |
Centers for Medicare & Medicaid Services (CMS) |
|
| Scoring Method |
Measure Type |
Stratification |
Risk Adjustment |
| Proportion |
PROCESS |
None |
None |
Rate Aggregation
None
Improvement Notation
A higher score indicates better quality
Rationale
Patients living with heart failure often have poor functional status and health-related quality of life, which declines as the disease progresses (Allen et al., 2012). In addition, their care is often complicated by multiple comorbidities. To assist in managing these complex patients, the American College of Cardiology Foundation and American Heart Association recommend collecting initial and repeat assessments of a patient's function and ability to complete desired activities of daily living (Hunt et al., 2009). The American Heart Association has also released scientific statements emphasizing the collection of patient-reported health status (for example, functional limitations, symptom burden, quality of life) from heart failure patients as an important means of establishing a dynamic conversation between patient and provider regarding care goals and the patient's priorities (Allen et al., 2012; Rumsfeld et al., 2013).
Clinical Recommendation Statement
American College of Cardiology Foundation and American Heart Association (2013): While this guideline does not explicitly recommend the use of patient-reported functional status or quality of life assessments (such as the Kansas City Cardiomyopathy Questionnaire or Minnesota Living with Heart Failure Questionnaire), it does “refer to meaningful survival a state in which HRQOL [health-related quality of life] is satisfactory to the patient.” The guideline also includes quality of life assessments in its description of a detailed plan of care for patients with chronic heart failure.
Definition
None
Transmission Format
TBD
Applicable Value Sets
References
CITATIONAllen, L. A., Stevenson, L. W., Grady, K. L., et al. (2012). Decision making in advanced heart failure: A scientific statement from the American Heart Association. Circulation, 125(15), 1928-1952. doi: 10.1161/CIR.0b013e31824f2173
CITATIONAmerican College of Cardiology Foundation & American Heart Association. (2013). Guideline for the management of heart failure: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 128(16), e240-e327. doi: 10.1161/CIR.0b013e31829e8776
CITATIONHunt, S. A., Abraham, W. T., Chin, M. H., et al. (2009). 2009 focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management of heart failure in adults. Circulation, 119(14), e391-e479. doi: 10.1161/CIRCULATIONAHA.109.192065
CITATIONRumsfeld, J. S., Alexander, K. P., Goff, D. C., et al. (2013). Cardiovascular health: The importance of measuring patient-reported health status: A scientific statement from the American Heart Association. Circulation, 127(22), 2233-2249. doi: 10.1161/CIR.0b013e3182949a2e
Disclaimer
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Copyright
This Physician Performance Measure (Measure) and related data specifications are owned and stewarded by the Centers for Medicare & Medicaid Services (CMS). CMS contracted (Contract HHSP23320095627WC; HHSP23337008T) with the National Committee for Quality Assurance (NCQA) to develop this electronic measure. NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications.
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Source:
https://ecqi.healthit.gov/ecqm/measures/cmsv1