2025 ACQR16 COPD Exacerbation or CHF Exacerbation requiring Hospital Admission: Palliative Care Evaluation

Measure Title: COPD Exacerbation or CHF Exacerbation requiring Hospital Admission: Palliative Care Evaluation

Measure Description: Patients admitted with 2 or more COPD exacerbations in 12 months or a single admission for COPD with hypercapnic respiratory failure, or being discharged to a SNF or LTACH should receive an evaluation from a palliative care professional, if available; and patients admitted with AHA Class D heart failure and/or patients admitted with Congestive Heart Failure (any class) being discharged to a SNF or LTACH should receive an evaluation from a palliative care professional, if available

Denominator: Sum of (All Patients >= 18 years of age being treated as inpatients with primary diagnosis of COPD Exacerbation for whom, (a) this is their second (or more) admission for COPD exacerbation within the preceding 12 months; (b) they are being treated for hypercarbic respiratory failure (pCO2>50 mmHg); or (c) they are being discharged to a SNF or LTACH) + (All Patients >= 65 years of age discharged from inpatient hospitalization with Class D CHF and for whom their primary admission diagnosis of CHF Exacerbation, and/or patients with a primary discharge diagnosis of CHF being discharged to a SNF or LTACH)

Denominator Exclusion: Patients who expire in the current hospital stay or are transferred to another acute care hospital

Numerator: Patients who have had a palliative care evaluation within 6 months of discharge

National Quality Forum (NQF) number, if applicable

N/A

Care setting(s)
Hospital

Telehealth, if applicable

Yes

Number of performance rates required for measures
1

Traditional vs. inverse measure
Traditional

Proportional, continuous variable, and/or ratio measure indicator
Proportional

Risk adjustment, if applicable
No

Submission pathway
Traditional MIPS