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Heart Failure

The PMC reviewed relevant performance measures and makes the following recommendations.

Printable version of the recommendations.
Addendum to printable version of the recommendations.

 ID #Measure NameRecommendation
NQF 0028
PQRS 226

Preventive Care & Screening: Tobacco Use: Screening & Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use at least once during the two-year measurement period AND who received cessation counseling intervention if identified as a tobacco user
Date Reviewed: April 7, 2014

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NQF 0079
PQRS 198

Heart Failure: Left Ventricular Ejection Fraction Assessment (Outpatient Setting)
Percentage of patients aged 18 years and older with a diagnosis of heart failure for whom the quantitative or qualitative results of a recent or prior (any time in the past) LVEF assessment is documented within a 12 month period
Date Reviewed: July 26, 2014

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NQF 0081
PQRS 5

Heart Failure: Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction
Percentage of patients aged 18 years and older with a diagnosis of heart failure with a current or prior LVEF < 40% who were prescribed ACE inhibitor or ARB therapy either within a 12 month period when seen in the outpatient setting or at hospital discharge
Date Reviewed: July 26, 2014

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NQF 0083
PQRS 8

Heart Failure: Beta-blocker therapy for Left Ventricular Systolic Dysfunction
Percentage of patients aged 18 years and older with a diagnosis of heart failure with a current or prior LVEF < 40% who were prescribed beta-blocker therapy either within a 12 month period when seen in the outpatient setting or at hospital discharge
Date Reviewed: July 26, 2014

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NQF 0162 (No longer NQF endorsed, but used in Hospital Inpatient Quality Reporting programs)

ACEI or ARB Therapy for Left Ventricular Systolic Dysfunction-HF Patients
Percent of HF patients with LVSD who are prescribed an ACEI or ARB at hospital discharge. For purposes of this measure, LVSD is defined as chart documentation of a LVEF less than 40% or a narrative description of left ventricular systolic function consistent with moderate or severe systolic dysfunction.
Date Reviewed: November 7, 2015

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NQF 0229

Hospital 30-day, all-cause, risk-standardized mortality rate following heart failure hospitalization for patients 18 and older
The measure estimates a hospital 30-day risk-standardized mortality rate. Mortality is defined as death for any cause within 30 days after the date of admission of the index admission, for patients 18 and older discharged from the hospital with a principal diagnosis of HF. CMS annually reports the measure for patients who are 65 years or older and are either enrolled in fee-for-service Medicare and hospitalized in non-federal hospitals or are hospitalized in VA facilities.
Date Reviewed: November 7, 2015

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NQF 0277

Heart Failure Admission Rate (PQI 8)
Admissions with a principal diagnosis of heart failure per 100,000 populations, ages 18 years and older. Excludes cardiac procedure admissions, obstetric admissions, and transfers from other institutions.
NOTE: The software provides the rate per population. However, common practice reports the measure as per 100,000 population. The user must multiply the rate obtained from the software by 100,000 to report admissions per 100,000.
Date Reviewed: November 7, 2015

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NQF 0330

Hospital 30-Day, all-cause, risk standardized readmission rate following heart failure hospitalization
The measure estimates a hospital-level risk-standardized readmission rate (RSRR) for patients discharged from the hospital with a principal diagnosis of heart failure (HF). The outcome is defined as unplanned readmission for any cause within 30 days of the discharge date for the index admission. A specified set of planned readmissions do not count as readmissions. The target population is patients 18 and over. CMS annually reports the measure for patients who are 65 years or older and are either enrolled in fee-for-service (FFS) Medicare and hospitalized in non-federal hospitals or are hospitalized in Veterans Health Administration (VA) facilities.
Date Reviewed: November 7, 2015

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NQF 2438

Beta-Blocker Therapy (i.e., Bisoprolol, Carvedilol, or Sustained-Release Metoprolol Succinate) for LVSD Prescribed at Discharge
Proportion of heart failure patients age18 and older with LVSD for whom beta-blocker therapy (i.e., bisoprolol, carvedilol, or sustained-release metoprolol succinate) is prescribed at discharge. For purposes of this measure, LVSD is defined as chart documentation of a left ventricular ejection fraction (LVEF) less than 40% or a narrative description of left ventricular systolic (LVS) function consistent with moderate or severe systolic dysfunction.
Date Reviewed: November 7, 2015

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NQF 2439

Post-Discharge Appointment for Heart Failure Patients
Patients for whom a follow-up appointment, including location, date, and time, for an office or home health visit for management of heart failure was scheduled within 7 days post-discharge and documented.
Date Reviewed: November 7, 2015

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NQF 2443

Post-Discharge Evaluation for Heart Failure Patients
Patients who receive a re-evaluation for symptoms worsening and treatment compliance by a program team member within 72 hours after inpatient discharge.
Date Reviewed: November 7, 2015

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