
I was recently asked how eligible professionals should report the Meaningful Use Clinical Quality Measures if there are zero denominators (i.e. you do not have any hypertensives, adults, or patients with 2 or more visits in the measurement period).
Here’s the answer as I understand the regulations and FAQs:
1. Report on the 3 Core measures if you can, which include
*Hypertension: Blood Pressure Measurement
*Tobacco Use Assessment and Tobacco Cessation Intervention
*Adult Weight Screening and Follow-up
2. If any of the 3 Core measures has a zero denominator, replace them one-for-one with one of the 3 alternate core measures. If you can’t get to 3 non-zero denominators between the core and alternate core, report on all 6 (even if it means that you have to report 6 zero denominators)
*Weight Assessment and Counseling for Children and Adolescents
*Preventive Care and Screening: Influenza Immunization for Patients ≥ 50 Years Old
*Childhood Immunization Status
3. Regardless of the above, you MUST report on 3 of the remaining 38 Additional Set measures. If you are reporting any zero denominators from these Additional Set measures, you must attest that you have no other non-zero denominator measures. Essentially, you have to confirm that you’re not running away from non-zero denominator measures.
In summary, the minimal requirement is for 6 measures (3 core or alternate core, 3 additional set). You may have to report up to 9 measures if there are zero denominators involved. If you can’t find 3 non-zero denominators among the core and alternate core, you have to report on all 6 (even if it means that you’re reporting 6 zero denominators). In addition, you still have to report on 3 from the remaining 38 additional set measures. If any of these 3 additional set measures is a zero denominator, you must confirm that you don’t have a non-zero denominator for any of the remaining 35 that you’re not reporting on.
Micky Tripathi posted a blog about this last summer that provides additional detail.
You’ll find the FAQs that address the Clinical Quality Measures here.
In addition to his CIO role at BIDMC, Dr. Halamka blogs at GeekDoctor.blogspot.com.