regression (Cox, 1972; SAS Institute Inc., 2004; Kalbfleisch and Prentice, 2002; Collett, 1994). The numerator of the The cost measure denominator The following episode-level exclusions apply: Colonoscopy Screening/Surveillance is the number of episodes (a) The beneficiary has a primary Colonoscopy cost from the Screening/Surveillance payer other than Medicare for any measure is the sum of Colonoscopy episode group amount of time overlapping the the ratio of observed to attributed to a clinician. episode window or in the 120 days expected prior to the episode trigger day. cost to (b) No attributed clinician is found for Medicare for all the episode. episodes attributed to a (c) The episode is not attributed to at clinician. This is then least one main clinician. multiplied by the (d) The beneficiary’s date of birth is national average missing. observed episode cost to (e) The beneficiary’s death date generate a dollar figure. occurred before the trigger date. (f) The beneficiary’s date occurred before the episode ended. (g) The beneficiary was not enrolled in Medicare Part A and B for the entirety of the 120-day lookback period plus episode window, or is enrolled in Part C for any part of the lookback period plus episode window. (h) The episode trigger was not performed in an office, IP, OP, or ASC setting based on its place of service. CoreQ: Short Stay The numerator is the The denominator includes all of Exclusions made at the time of Discharge sum of the individuals in the patients that are admitted to sample selection and the following: Measure the facility that have an the SNF, regardless of payor (1) Patients who died during SNF average satisfaction source, for post-acute care, that stay; (2) Patients discharged to a score of greater than or are discharged within 100 days; hospital, another SNF, psychiatric
regression (Cox, 1972; SAS Institute Inc., 2004; Kalbfleisch and Prentice, 2002; Collett, 1994). Colonoscopy The numerator of the Screening/Surveillance Colonoscopy cost measure is the sum of the ratio of observed to expected cost to Medicare for all episodes attributed to a clinician. This is then multiplied by the national average observed episode cost to generate a dollar figure. The cost measure denominator is the number of episodes from the Screening/Surveillance Colonoscopy episode group attributed to a clinician. The following episode-level exclusions apply: (a) The beneficiary has a primary payer other than Medicare for any amount of time overlapping the episode window or in the 120 days prior to the episode trigger day. (b) No attributed clinician is found for the episode. (c) The episode is not attributed to at least one main clinician. (d) The beneficiary’s date of birth is missing. (e) The beneficiary’s death date occurred before the trigger date. (f) The beneficiary’s date occurred before the episode ended. (g) The beneficiary was not enrolled in Medicare Part A and B for the entirety of the 120-day lookback period plus episode window, or is enrolled in Part C for any part of the lookback period plus episode window. (h) The episode trigger was not performed in an office, IP, OP, or ASC setting based on its place of service. CoreQ: Short Stay Discharge Measure The numerator is the sum of the individuals in the facility that have an average satisfaction score of greater than or The denominator includes all of the patients that are admitted to the SNF, regardless of payor source, for post-acute care, that are discharged within 100 days; Exclusions made at the time of sample selection and the following: (1) Patients who died during SNF stay; (2) Patients discharged to a hospital, another SNF, psychiatric