CMS 144 - Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)

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Covered by this topic

Overview

CMS144v8 (2020)

CMS144v9 (2021)

CMS144v10 (2022)

Identifiers

CMS eCQM IDNQF eCQM IDNQFMIPS Quality ID
CMS144v100083e0083008

*MIE only supports data collection and reporting using eCQM specifications

Definitions

DescriptionPercentage 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
Initial Patient PopulationAll patients aged 18 years and older with a diagnosis of heart failure
DenominatorEquals Initial Population with a current or prior LVEF < 40%
Denominator Exclusions–
NumeratorPatients who were prescribed beta-blocker therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge
Numerator Exclusions–
Denominator Exceptions
  • Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons).
  • Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons).
  • Documentation of system reason(s) for not prescribing beta-blocker therapy (e.g., other reasons attributable to the healthcare system).

Additional Information

Measure TypeProcess measure
Measure ScoringProportion measure
Rate AggregationPopulation 1: Patients who were prescribed beta-blocker therapy within a 12-month period when seen in the outpatient setting
Population 2: Patients who were prescribed beta-blocker therapy at each hospital discharge

Performance Rate = (Numerator 1 + Numerator 2)/ [(Denominator 1 - Denominator Exceptions 1) + (Denominator 2 - Denominator Exceptions 2)]
GranularityPatient
Improvement NotationHigher score indicates better quality
DomainEffective Clinical Care

Clinical Instructions

New UI Visit Encounter (valid RC202109+)

Original Visit Encounter

Track all patients aged 18+ prescribed beta-blocker therapy within a 12-month period of the diagnosis of heart failure with a current or prior left ventricular ejection fraction (LVEF) < 40%.

  1. Ensure patient has one of the following diagnoses:
    1. Moderate left ventricular systolic dysfunction (disorder) - SNOMED 981000124106
    2. Severe left ventricular systolic dysfunction (disorder) - SNOMED 991000124109
  2. Numerator will be populated with patients prescribed a beta-blocker therapy within the measurement period.

Evidence

Initial Patient Population

NameValue Set
Diagnosis: Heart Failure2.16.840.1.113883.3.526.3.376
Encounter, Performed: Care Services in Long-Term Residential Facility2.16.840.1.113883.3.464.1003.101.12.1014
Encounter, Performed: Discharge Services - Hospital Inpatient2.16.840.1.113883.3.464.1003.101.12.1007
Encounter, Performed: Home Healthcare Services2.16.840.1.113883.3.464.1003.101.12.1016
Encounter, Performed: Nursing Facility Visit2.16.840.1.113883.3.464.1003.101.12.1012
Encounter, Performed: Office Visit2.16.840.1.113883.3.464.1003.101.12.1001
Encounter, Performed: Outpatient Consultation2.16.840.1.113883.3.464.1003.101.12.1008
Encounter, Performed: Patient Provider Interaction2.16.840.1.113883.3.526.3.1012

Denominator

NameValue Set
Diagnosis: Left ventricular systolic dysfunction (disorder)SNOMEDCT Code 134401001
Diagnosis: Moderate or Severe LVSD2.16.840.1.113883.3.526.3.1090
Diagnostic Study, Performed: Ejection Fraction2.16.840.1.113883.3.526.3.1134

Numerator

NameValue Set
Medication, Active: Beta Blocker Therapy for LVSD"2.16.840.1.113883.3.526.3.1184

Denominator Exceptions

NameValue Set
Allergy/Intolerance: Beta Blocker Therapy Ingredient2.16.840.1.113883.3.526.3.1493
Allergy/Intolerance: Substance with beta adrenergic receptor antagonist mechanism of action (substance)SNOMEDCT Code 373254001
Device, Applied: Cardiac Pacer2.16.840.1.113883.3.526.3.1193
Diagnosis: Allergy to Beta Blocker Therapy2.16.840.1.113883.3.526.3.1177
Diagnosis: Arrhythmia2.16.840.1.113883.3.526.3.366
Diagnosis: Asthma2.16.840.1.113883.3.526.3.362
Diagnosis: Atrioventricular Block2.16.840.1.113883.3.526.3.367
Diagnosis: Bradycardia2.16.840.1.113883.3.526.3.412
Diagnosis: Cardiac Pacer in Situ2.16.840.1.113883.3.526.3.368
Diagnosis: Hypotension2.16.840.1.113883.3.526.3.370
Diagnosis: Intolerance to Beta Blocker Therapy2.16.840.1.113883.3.526.3.1178
Physical Exam, Performed: Heart Rate2.16.840.1.113883.3.526.3.1176

Source(s)

eCQI CMS144

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