Below is the most recently endorsed version of the measure specifications:
Measure Description:
30-Day Unplanned Readmissions for Cancer Patients measure is a cancer-specific measure. It provides the rate at which all adult cancer patients covered as Fee-for-Service Medicare beneficiaries have an unplanned readmission within 30 days of discharge from an acute care hospital. The unplanned readmission is defined as a subsequent inpatient admission to a short-term acute care hospital, which occurs within 30 days of the discharge date of an eligible index admission and has an admission type of “emergency” or “urgent.”
Numerator Statement:
This outcome measure demonstrates the rate at which adult cancer patients have unplanned readmissions within 30 days of discharge from an eligible index admission. The numerator includes all eligible unplanned readmissions to any short-term acute care hospital—defined as admission to a PPS-Exempt Cancer Hospital (PCH), a short-term acute care Prospective Payment (PPS) hospital, or Critical Access Hospital (CAH)—within 30 days of the discharge date from an index admission that is included in the measure denominator. Readmissions with an admission type (UB-04 Uniform Bill Locator 14) of “emergency = 1” or “urgent = 2” are considered unplanned readmissions within this measure. Readmissions for patients with progression of disease (using a principal diagnosis of metastatic disease as a proxy) and for patients with planned admissions for treatment (defined as a principal diagnosis of chemotherapy or radiation therapy) are excluded from the measure numerator.
Numerator Details:
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Denominator Statement:
The denominator includes inpatient admissions for all adult Fee-for-Service Medicare beneficiaries where the patient is discharged from a short-term acute care hospital (PCH, short-term acute care PPS hospital, or CAH) with a principal or secondary diagnosis (i.e., not admitting diagnosis) of malignant cancer within the defined measurement period.
Denominator Details:
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Exclusions:
The following index admissions are excluded from the measure denominator:
1) Less than 18 years of age;
2) Patients who died during the index admission;
3) Patients discharged AMA;
4) Patients transferred to another acute care hospital during the index admission;
5) Patients discharged with a planned readmission;
6) Patients having missing or incomplete data; and,
7) Patients not admitted to an inpatient bed.
Exclusion Details:
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Risk Adjustment:
Statistical risk model
Classification:
Measure Type:
Outcome
Measure Format:
measure
Condition:
Non-Condition Specific:
Care Setting:
Inpatient/Hospital
National Quality Strategy Priorities:
Readmissions, Patient Safety
Current Use:
Payment Program, Public Reporting, Quality Improvement (Internal to the specific organization), Quality Improvement with Benchmarking (external benchmarking to multiple organizations)
Planned Use:
Data Source:
Claims
Level of Analysis:
Facility
Target Population:
Outcome-Focused, Patient-and Caregiver-Focused, Coordinated and Integrated Care, Lowest Data Collection Burden, Highly Prevalent Conditions
Measure Steward Contact Information:
For additional measure specification information, please contact the Measure Steward.
Measure Steward Organization:
Seattle Cancer Care Alliance
Primary Measure Steward Contact:
Measure Steward Copyright:
N/A
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