Measure ID: REGCLR1 - 2023
Measure Title: Heel Pain Treatment Outcomes for Adults
Measure Description:
Percentage of patients aged 18 and older with a diagnosis of heel pain who receive an intervention intended to treat the heel pain and experience a clinically significant decrease in heel pain. Patients who have had at least two visits during the reporting period
Denominator:
All patients aged 18 and older on the date of initial encounter for one of the diagnosis codes associated with this measure. (M77.31, M77.32, M72.2)
AND
Are provided an intervention to address their pain
Interventions include:
Surgical Interventions
Shoe wear modifications
Orthotics
Night Splints
Physical Therapy
AND
Report a level of pain of 3 or more on a scale of 1 – 10 on the initial visit
Numerator:
Patients in the denominator who have an intervention to treat the heel pain.
Interventions include:
Dispensing of Custom Orthotics
Dispensing of Pre Fabricated Orthotics
Injections for heel pain
Dispensing of Night Splints
Education on Stretching
Providing Physical Therapy
Definition:
Heel Pain Evaluation – Consists of a documented evaluation of patient reported pain level utilizing a standardized pain scale.
Performance Met:
Heel Pain Decreased Significantly (second value equal to or less than 50% of the initial value) (MX012)
OR
Performance Not Met:
Heel Pain Level Not Documented (MX013)
Heel Pain Not Decreased by at least 50% (MX014)
Denominator Exclusions:
Clinician documented that the patient was not an eligible candidate for evaluation of heel pain. For example, the patient has a condition that would not allow them to accurately respond to a pain level exam (Dementia, Alzheimer's, patient has previously documented diabetic peripheral neuropathy with loss of protective sensation)
Patients who have been prescribed Opioids
Denominator Exceptions: None
Numerator Exclusions: None
NQF ID: N/A
High Priority: Yes
Measure Type: Patient-Reported Outcome-based Performance Measure (PRO-PM)
Care Setting: Ambulatory Care: Clinician Office/Clinic
Includes Telehealth? No
Number of performance rates to be submitted: 1
Performance Rate Description(s): Patients with heel pain that demonstrate improvement in pain level
Traditional vs Inverse measure: Traditional
Proportional, continuous variable, and/or ratio measure indicator: Proportional
Risk-Adjusted: No
Submission Pathway: Traditional MIPS