Measure ID : REGCLR6 - 2023 - Note this measure has significantly changed since 2022
Measure Title : Monitor and Improve Treatment Outcomes in Chronic Wound Healing
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.
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)
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
Have not been classified as a “palliative” case by their provider
Visit, or are visited by, a provider that re-assesses the chronic wound .
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
Patient has documented noncompliance with the treatment plan
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