Measure ID : REGCLR6 - 2023 - Note this measure has significantly changed since 2022
Measure Title : Monitor and Improve Treatment Outcomes in Chronic Wound Healing
Measure Description:
This measure is specifically for CHRONIC wounds. Those are wounds that have been present for an extended period of time and have not demonstrated healing.
Percentage of patients presenting with a non-healing (chronic) wound (present for 6 weeks with no or limited response to treatment) who are currently visiting a provider responsible for their wound care, who performs a re-assessment of the wound (The use of digital imaging to monitor the wound is encouraged) , and has used the information learned from that re-assessment to implement a change in treatment plan, and whose wound healing rate has accelerated since implementation of the updated treatment plan.
Denominator:
All patients with a chronic wound whose provider(s) have re-assessed the wound and changed treatment plans as a result of the re-assessment and have not been classified as a “palliative” patient i.e. a patient without the capacity to heal.
The use of a software based wound surface assessment tool is highly encouraged. A wound surface area assessment tool is one that uses machine vision to derive accurate wound measurements from a digital image. This software can be a commercially available software or free software that is downloadable from the NIH (Image J)
Denominator Criteria
Patients with the diagnosis of a chronic wound (ICD-10):
L97.401, L97.402, L97.403, L97.404, L97.406, L97.408, L97.409, L97.411, L97.412, L97.413, L97.414, L97.416, L97.418, L97.419, L97.421, L97.422, L97.423, L97.424, L97.426, L97.428, L97.429, L97.501, L97.502, L97.503, L97.504, L97.606, L97.508, L97.509, L97.511, L97.512, L97.513, L97.514, , L97.516, L97.518, L97.519, L97.521, L97.522, L97.523, L97.524, L97.526, L97.528 L97.529
AND
Have not been classified as a “palliative” case by their provider
AND
Visit, or are visited by, a provider that re-assesses the chronic wound .
Numerator:
All patients whose rate of wound healing, as measured by weekly surface area changes, improved after a change in treatment plan based upon information learned from the re-assessment of the wound.
Performance Met: Patient’s wound healing rate, as measured by changes in surface area over time, improves by at least 25% within 4 weeks after the change in treatment plan
Performance Not Met: Patient’s wound healing rate, as measured by changes in surface area over time, stagnates or worsens within 4 weeks after the change in treatment plan
Denominator Exclusions:
Patient has documented noncompliance with the treatment plan
OR
Patient fails to follow up for regular visits at 4 weeks after beginning measurement with digital device
Denominator Exceptions: None
Numerator Exclusions: None
NQF ID : N/A
High Priority: Yes
Measure Type: Outcome
Care Setting: Ambulatory Care: Clinician Office/Clinic
Includes Telehealth?: No
Number of performance rates to be submitted: 1
Traditional vs Invese measure : Traditional
Proportional, continuous variable, and/or ratio measure indicator : Proportional
Risk Adjusted: No
Submission Pathway: Traditonal MIPS