Measure Source

CMS Health Care Quality Improvement Program (HCQIP) Quality Indicator.

Tables

Data source does not support detailed tables.

Data Source

Centers for Medicare and Medicaid Services, Medicare Quality Improvement Organization Program.

Denominator

Medicare live discharges age 18 and over meeting both of the following criteria:

1. Principal diagnosis of heart failure (ICD-9 codes 402.01, 402.11, 402.91, 404.01, 404.11, 404.91, 428.x)
2. Documented left ventricular function evaluation not consistent with left ventricular systolic dysfunction (ejection fraction less than 40% or equivalent narrative description)

Numerator

Subset of denominator who meet at least one of the following three conditions:

1. On ACEI at discharge.
2. Chart documentation of one or more of the following contraindications to ACEI use: moderate or severe aortic stenosis; or bilateral renal artery stenosis; or history of angioedema, hives or severe rash with ACEI use.
3. Physician documentation of any specific reason why ACEI is not used.

Comments

Excludes patients transferred to another acute care hospital, patients who expired, patients who left against medical advice, patients on dialysis, patients on ARB but not ACEI at discharge, patients participating in a clinical trial testing alternatives to ACEIs as first-line heart failure therapy.