Hospital Visits For each ASC, the The denominator is the number Procedures for patients who survived following General numerator of the ratio is of hospital visits expected at least 7 days, but were not Surgery the number of hospital nationally for the ASC’s continuously enrolled in Medicare Ambulatory visits predicted for the case/procedure mix. FFS Parts A and B in the 7 days after Surgical Center ASC’s patients, the surgery are excluded. These Procedures accounting for its patients are excluded to ensure all observed rate, the patients have full data available for number and complexity outcome assessment. of general surgery procedures performed at the ASC, and the case mix. Ischemic Vascular Denominator patients 18 years or older at the start of The following exclusions are allowed Disease Use of with documentation the measurement period AND to be applied to the eligible Aspirin or that the patient was on less than 76 years at the end of population: daily aspirin or the measurement period - Patient was a permanent nursing Medication medication AND home resident at any time during the during the measurement Patient had a diagnosis of measurement period period, unless allowed ischemic vascular disease - Patient was in hospice or receiving contraindications or (Ischemic Vascular Disease Value palliative care at any time during the exceptions are present. Set) with any contact during the measurement period current or prior measurement - Patient died prior to the end of the period OR had ischemic vascular measurement period disease (Ischemic Vascular - Documentation that diagnosis was Disease Value Set) present on an coded in error active problem list at any time - Patient had only urgent care visits during the measurement period. during the measurement period AND At least one established patient office visit (Established Pt Diabetes & Vasc Value Set) for any reason during the measurement period The following episode-level Routine Cataract The numerator of the The cost measure denominator exclusions apply: Removal with Routine Cataract is the total number of episodes (a) The beneficiary has a primary Intraocular Lens Removal with IOL from the Routine Cataract payer other than Medicare for any (IOL) Implantation Implantation cost Removal with IOL Implantation
Hospital Visits following General Surgery Ambulatory Surgical Center Procedures For each ASC, the numerator of the ratio is the number of hospital visits predicted for the ASC’s patients, accounting for its observed rate, the number and complexity of general surgery procedures performed at the ASC, and the case mix. The denominator is the number of hospital visits expected nationally for the ASC’s case/procedure mix. Procedures for patients who survived at least 7 days, but were not continuously enrolled in Medicare FFS Parts A and B in the 7 days after the surgery are excluded. These patients are excluded to ensure all patients have full data available for outcome assessment. Ischemic Vascular Disease Use of Aspirin or Medication Denominator patients with documentation that the patient was on daily aspirin or medication during the measurement period, unless allowed contraindications or exceptions are present. 18 years or older at the start of the measurement period AND less than 76 years at the end of the measurement period AND Patient had a diagnosis of ischemic vascular disease (Ischemic Vascular Disease Value Set) with any contact during the current or prior measurement period OR had ischemic vascular disease (Ischemic Vascular Disease Value Set) present on an active problem list at any time during the measurement period. AND At least one established patient office visit (Established Pt Diabetes & Vasc Value Set) for any reason during the measurement period The following exclusions are allowed to be applied to the eligible population: - Patient was a permanent nursing home resident at any time during the measurement period - Patient was in hospice or receiving palliative care at any time during the measurement period - Patient died prior to the end of the measurement period - Documentation that diagnosis was coded in error - Patient had only urgent care visits during the measurement period Routine Cataract Removal with Intraocular Lens (IOL) Implantation The numerator of the Routine Cataract Removal with IOL Implantation cost The cost measure denominator is the total number of episodes from the Routine Cataract Removal with IOL Implantation The following episode-level exclusions apply: (a) The beneficiary has a primary payer other than Medicare for any