Below is the most recently endorsed version of the measure specifications:
Measure Description:
The measure estimates a hospital-level 30-day, all-cause, risk-standardized readmission rate (RSRR) for patients age 65 and older discharged from the hospital with a principal diagnosis of acute myocardial infarction (AMI). Readmission is defined as unplanned readmission for any cause within 30 days of the discharge date for the index admission. Readmissions are classified as planned and unplanned by applying the planned readmission algorithm. CMS annually reports the measure for patients who are 65 years or older and enrolled in fee-for-service (FFS) Medicare and hospitalized in non-federal hospitals or are patients hospitalized in Veterans Health Administration (VA) facilities.
Numerator Statement:
The outcome for this measure is 30-day all-cause readmissions. We define readmission as an inpatient acute care admission for any cause, with the exception of certain planned readmissions, within 30 days from the date of discharge from the index for patients 65 and older discharged from the hospital with a principal discharge diagnosis of AMI. If a patient has more than one unplanned admission (for any reason) within 30 days after discharge from the index admission, only the first one is counted as a readmission. The measure looks for a dichotomous yes or no outcome of whether each admitted patient has an unplanned readmission within 30 days. However, if the first readmission after discharge is considered planned, any subsequent unplanned readmission is not counted as an outcome for that index admission because the unplanned readmission could be related to care provided during the intervening planned readmission rather than during the index admission.
Additional details are provided in S.5 Numerator Details.
Numerator Details:
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Denominator Statement:
The cohort includes admissions for patients aged 65 years and older discharged from the hospital with a principal diagnosis of AMI; and with a complete claims history for the 12 months prior to admission.
Additional details are provided in S.7 Denominator Details.
Denominator Details:
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Exclusions:
The 30-day AMI readmission measure excludes index admissions for patients:
1) Without at least 30 days of post-discharge enrollment in Medicare FFS (in the case of patients who are not VA beneficiaries);
2) Discharged against medical advice (AMA);
3) Same-day discharges; or
4) Admitted within 30 days of a prior index admission for AMI.
Exclusion Details:
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Risk Adjustment:
Statistical risk model
Classification:
Measure Type:
Outcome
Measure Format:
measure
Condition:
Cardiovascular, Coronary Artery Disease (AMI)
Non-Condition Specific:
Care Coordination, Safety: Complications, Safety: Overuse, Safety
Care Setting:
Inpatient/Hospital
National Quality Strategy Priorities:
Patient Safety
Current Use:
Payment Program, Public Reporting
Planned Use:
Data Source:
Claims, Enrollment Data, Other
Level of Analysis:
Facility
Target Population:
Elderly, Populations at Risk
Highest Opportunity for Improvement, Highly Prevalent Conditions, Outcome-Focused, Patient-and Caregiver-Focused
Measure Steward Contact Information:
For additional measure specification information, please contact the Measure Steward.
Measure Steward Organization:
Centers for Medicare & Medicaid Services
Primary Measure Steward Contact:
Measure Steward Copyright:
N/A
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