Measure Title: Patients Suffering From a Knee Injury who Improve Physical Function
Measure Owner: Patient360 in Collaboration with ETSU & Limber Health
Measure Description: Percentage of patients 18 years or older suffering from a Knee injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Physical Function Computer Adaptive Testing, mapped legacy measure, or like tool of measurement. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers, the measure is risk-adjusted based on age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
This measure will include three rates:
1) The number of non-surgical patients achieving a score change greater than or equal to the MCID in PROMIS Physical Function or like mapped measure.
2) The number of surgical patients achieving a score change greater than or equal to the MCID in PROMIS Physical Function or like mapped measure.
3) The overall performance rate of Rate 1 and Rate 2 combined.
Denominator: All patients 18 years or older with a knee injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Numerator: Number of patients aged 18 years or older with a knee injury who achieve an overall score change of 2.1 points in PROMIS Physical Function or like mapped measure.
Denominator Exclusions: Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation. Patients where score change cannot be measured due to lack of 2+ completed surveys within the measurement window.
Denominator Exceptions: Physical Therapists can exclude patients based on an evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway. Patients may also be excluded if they are seen for less than 3 visits.
High Priority Measure? Yes High Priority Type: OUTCOMES
Measure Type: Patient Reported Outcome based Performance Measure (PRO-PM)
NQS Domain: Effective Clinical Care
Care Setting: Ambulatory Care: Clinician Office/Clinic
Includes Telehealth? Yes
Measure Title: Patients Suffering From a Lumbar Spine (Low Back) Injury who Improve Physical Function
Measure Owner: Patient360 in Collaboration with ETSU & Limber Health
Measure Description:
Percentage of patients 18 years or older suffering from a Lumbar Spine (Low Back) injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Physical Function Computer Adaptive Testing, mapped legacy measure, or like tool of measurement. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers, the measure is risk-adjusted based on age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
This measure will include three rates:
1) The number of non-surgical patients achieving a score change greater than or equal to the MCID in PROMIS Physical Function or like mapped measure.
2) The number of surgical patients achieving a score change greater than or equal to the MCID in PROMIS Physical Function or like mapped measure
3) The overall performance rate of Rate 1 and Rate 2 combined.
Denominator: All patients 18 years or older with a lumbar spine (low back) injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Numerator: Number of patients aged 18 years or older with a lumbar spine (low back) injury who achieve an overall score change of 2.1 points in PROMIS Physical Function or like mapped measurement tool.
Denominator Exclusions: Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation. Patients where score change cannot be measured due to lack of 2+ completed surveys within the measurement window.
Denominator Exceptions: Physical Therapists can exclude patients based on an evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway. Patients may also be excluded if they are seen for less than 3 visits.
High Priority Measure? Yes High Priority Type: OUTCOMES
Measure Type: Patient Reported Outcome based Performance Measure (PRO-PM)
NQS Domain: Effective Clinical Care
Care Setting: Ambulatory Care: Clinician Office/Clinic
Includes Telehealth? Yes
Which Meaningful Measure Area applies to this measure? Functional Outcomes
Measure Title: Patients Suffering From a Cervical Spine (Neck) Injury who Improve Physical Function
Measure Owner: Patient360 in Collaboration with ETSU & Limber Health
Measure Description:
Percentage of patients 18 years or older suffering from a Cervical Spine (neck) injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Physical Function Computer Adaptive Testing, mapped legacy measure, or like tool of measurement. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers, the measure is risk-adjusted based on age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
This measure will include three rates:
1) The number of non-surgical patients achieving a score change greater than or equal to the MCID in PROMIS Physical Function or like mapped measure.
2) The number of surgical patients achieving a score change greater than or equal to the MCID in PROMIS Physical Function or like mapped measure
3) The overall performance rate of Rate 1 and Rate 2 combined.
Denominator: All patients 18 years or older with a cervical spine (neck) injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Numerator: Number of patients aged 18 years or older with a cervical spine (neck) injury who achieve an overall score change of 2.1 points in PROMIS Physical Function or like mapped measurement tool.
Denominator Exclusions: Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation. Patients where score change cannot be measured due to lack of 2+ completed surveys within the measurement window.
Denominator Exceptions: Physical Therapists can exclude patients based on an evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway. Patients may also be excluded if they are seen for less than 3 visits.
High Priority Measure? Yes High Priority Type: OUTCOMES
Measure Type: Patient Reported Outcome based Performance Measure (PRO-PM)
NQS Domain: Effective Clinical Care
Care Setting: Ambulatory Care: Clinician Office/Clinic
Includes Telehealth? Yes
Which Meaningful Measure Area applies to this measure? Functional Outcomes
Measure Title: Patients Suffering From a Lower Extremity Injury who Improve Physical Function
Measure Owner: Patient360 in Colaboration with ETSU & Limber Health
Measure Description:
Percentage of patients 18 years or older suffering from a hip, foot, or ankle injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Physical Function Computer Adaptive Testing, mapped legacy measure, or like tool of measurement. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers, the measure is risk-adjusted based on age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
This measure will include three rates:
1) The number of non-surgical patients achieving a score change greater than or equal to the MCID in PROMIS Physical Function or like mapped measure.
2) The number of surgical patients achieving a score change greater than or equal to the MCID in PROMIS Physical Function or like mapped measure.
3) The overall performance rate of Rate 1 and Rate 2 combined.
Denominator: All patients 18 years or older with a hip,foot, or ankle injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Numerator: Number of patients aged 18 years or older with a hip injury who achieve an overall score change of 2.1 points in PROMIS Physical Function or like mapped measurement tool.
Denominator Exclusions: Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation. Patients where score change cannot be measured due to lack of 2+ completed surveys within the measurement window.
Denominator Exceptions: Physical Therapists can exclude patients based on an evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway. Patients may also be excluded if they are seen for less than 3 visits.
High Priority Measure? Yes High Priority Type: OUTCOMES
Measure Type: Patient Reported Outcome based Performance Measure (PRO-PM)
NQS Domain: Effective Clinical Care
Care Setting: Ambulatory Care: Clinician Office/Clinic
Includes Telehealth? Yes
Which Meaningful Measure Area applies to this measure? Functional Outcomes
Measure Title: Patients Suffering From a Upper Extremity Injury who Improve Physical Function
Measure Owner: Patient360 in Collaboration with ETSU & Limber Health
Measure Description:
Percentage of patients 18 years or older suffering from a shoulder, elbow, wrist/hand injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Upper Extremity Computer Adaptive Testing in the PROMIS Pain Interference Computer Adaptive Testing (CAT), mapped legacy measure, or like tool of measurement. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers, the measure is risk-adjusted based on age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
This measure will include three rates:
1) The number of non-surgical patients achieving a score change greater than or equal to the MCID in PROMIS Upper Extremity Function or like mapped measure.
2) The number of surgical patients achieving a score change greater than or equal to the MCID in PROMIS PROMIS Upper Extremity Function or like mapped measure.
3) The overall performance rate of Rate 1 and Rate 2 combined.
Denominator:All eligible patients 18 years or older with shoulder, elbow, wrist/hand injury evaluated and treated by a physical therapist (PT) or physical therapy group with a hip, ankle, or foot injury at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Numerator: Number of patients aged 18 years or older with shoulder, elbow, wrist/hand injury who achieve an overall score change of 2.0 points in PROMIS Pain Interference or like mapped measurement tool.
Denominator Exclusions: Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation. Patients where score change cannot be measured due to lack of 2+ completed surveys within the measurement window.
Denominator Exceptions: Physical Therapists can exclude patients based on an evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway. Patients may also be excluded if they are seen for less than 3 visits.
High Priority Measure? Yes High Priority Type: OUTCOMES
Measure Type: Patient Reported Outcome based Performance Measure (PRO-PM)
NQS Domain: Effective Clinical Care
Care Setting: Ambulatory Care: Clinician Office/Clinic
Includes Telehealth? Yes
Which Meaningful Measure Area applies to this measure? Functional Outcomes
Measure Title: Patients Suffering From a Knee Injury who Demonstrate Improved Pain
Measure Owner: Patient360 in Collaboration with ETSU & Limber Health
Measure Description:
Percentage of patients 18 years or older suffering from knee pain who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT), mapped legacy measure, or like tool of measurement. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers, the measure is risk-adjusted based on age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
This measure will include three rates:
1) The number of non-surgical patients achieving a score change greater than or equal to the MCID in PROMIS Pain Interference or like mapped measure.
2) The number of surgical patients achieving a score change greater than or equal to the MCID in PROMIS Pain Interference or like mapped measure.
3) The overall performance rate of Rate 1 and Rate 2 combined.
Denominator: All patients 18 years or older with knee injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Numerator: Number of patients aged 18 years or older with knee injury who achieve an overall score change of 2.0 points in PROMIS Pain Interference or or like mapped measurement tool..
Denominator Exclusions: Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation. Patients where score change cannot be measured due to lack of 2+ completed surveys within the measurement window.
Denominator Exceptions: Physical Therapists can exclude patients based on an evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway. Patients may also be excluded if they are seen for less than 3 visits.
High Priority Measure? Yes High Priority Type: OUTCOMES
Measure Type: Patient Reported Outcome based Performance Measure (PRO-PM)
NQS Domain: Effective Clinical Care
Care Setting: Ambulatory Care: Clinician Office/Clinic
Includes Telehealth? Yes
Which Meaningful Measure Area applies to this measure? Functional Outcomes
Measure Title: Patients Suffering From a Lumbar Spine (Low Back) Injury who Demonstrate Improved Pain
Measure Owner: Patient360 in Collaboration with ETSU & Limber Health
Measure Description:
Percentage of patients 18 years or older suffering from lumbar spine (low back) pain who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT), mapped legacy measure, or like tool of measurement. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers, the measure is risk-adjusted based on age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
This measure will include three rates:
1) The number of non-surgical patients achieving a score change greater than or equal to the MCID in PROMIS Pain Interference or like mapped measure.
2) The number of surgical patients achieving a score change greater than or equal to the MCID in PROMIS Pain Interference or like mapped measure.
3) The overall performance rate of Rate 1 and Rate 2 combined.
Denominator: All patients 18 years or older with lumbar spine (low back) injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Numerator: Number of patients aged 18 years or older with lumbar spine (low back) pain who achieve an overall score change of 2.0 points in PROMIS Pain Interference or or like mapped measurement tool..
Denominator Exclusions: Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation. Patients where score change cannot be measured due to lack of 2+ completed surveys within the measurement window.
Denominator Exceptions: Physical Therapists can exclude patients based on an evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway. Patients may also be excluded if they are seen for less than 3 visits.
High Priority Measure? Yes High Priority Type: OUTCOMES
Measure Type: Patient Reported Outcome based Performance Measure (PRO-PM)
NQS Domain: Effective Clinical Care
Care Setting: Ambulatory Care: Clinician Office/Clinic
Includes Telehealth? Yes
Which Meaningful Measure Area applies to this measure? Functional Outcomes
Measure Title: Patients Suffering From a Cervical Spine (Neck) Injury who Demonstrate Improved Pain
Measure Owner: Patient360 in Collaboration with ETSU & Limber Health
Measure Description:
Percentage of patients 18 years or older suffering from cervical spine (neck) injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT), mapped legacy measure, or like tool of measurement. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers, the measure is risk-adjusted based on age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
This measure will include three rates:
1) The number of non-surgical patients achieving a score change greater than or equal to the MCID in PROMIS Pain Interference or like mapped measure.
2) The number of surgical patients achieving a score change greater than or equal to the MCID in PROMIS Pain Interference or like mapped measure.
3) The overall performance rate of Rate 1 and Rate 2 combined.
Denominator: All patients 18 years or older with cervical spine (neck) pain evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Numerator: Number of patients aged 18 years or older with cervical spine (neck) pain who achieve an overall score change of 2.0 points in PROMIS Pain Interference or like mapped measurement tool..
Denominator Exclusions: Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation. Patients where score change cannot be measured due to lack of 2+ completed surveys within the measurement window.
Denominator Exceptions: Physical Therapists can exclude patients based on an evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway. Patients may also be excluded if they are seen for less than 3 visits.
High Priority Measure? Yes High Priority Type: OUTCOMES
Measure Type: Patient Reported Outcome based Performance Measure (PRO-PM)
NQS Domain: Effective Clinical Care
Care Setting: Ambulatory Care: Clinician Office/Clinic
Includes Telehealth? Yes
Which Meaningful Measure Area applies to this measure? Functional Outcomes
Measure Title: Patients Suffering From a Lower Extremity Injury who Demonstrate Improved Pain
Measure Owner: Patient360 in Collaboration with ETSU & Limber Health
Measure Description: Percentage of patients 18 years or older suffering from hip, ankle, or foot injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT), mapped legacy measure, or like tool of measurement. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers, the measure is risk-adjusted based on age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
This measure will include three rates:
1) The number of non-surgical patients achieving a score change greater than or equal to the MCID in PROMIS Pain Interference or like mapped measure.
2) The number of surgical patients achieving a score change greater than or equal to the MCID in PROMIS Pain Interference or like mapped measure.
3) The overall performance rate of Rate 1 and Rate 2 combined.
Denominator: All eligible patients 18 years or older with hip, ankle, or foot injury evaluated and treated by a physical therapist (PT) or physical therapy group with a hip, ankle, or foot injury at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Numerator: Number of patients aged 18 years or older with hip, ankle, or foot injury who achieve an overall score change of 2.0 points in PROMIS Pain Interference or like mapped measurement tool.
Denominator Exclusions: Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation. Patients where score change cannot be measured due to lack of 2+ completed surveys within the measurement window.
Denominator Exceptions: Physical Therapists can exclude patients based on an evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway. Patients may also be excluded if they are seen for less than 3 visits.
High Priority Measure? Yes High Priority Type: OUTCOMES
Measure Type: Patient Reported Outcome based Performance Measure (PRO-PM)
NQS Domain: Effective Clinical Care
Care Setting: Ambulatory Care: Clinician Office/Clinic
Includes Telehealth? Yes
Which Meaningful Measure Area applies to this measure? Functional Outcomes
Measure Title: Patients Suffering From a Upper Extremity Injury who Demonstrate Improved Pain
Measure Owner: Patient360 in Collaboration with ETSU & Limber Health
Measure Description:
Percentage of patients 18 years or older suffering from shoulder, elbow, wrist/hand injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT), mapped legacy measure, or like tool of measurement. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers, the measure is risk-adjusted based on age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
This measure will include three rates:
1) The number of non-surgical patients achieving a score change greater than or equal to the MCID in PROMIS Pain Interference or like mapped measure.
2) The number of surgical patients achieving a score change greater than or equal to the MCID in PROMIS Pain Interference or like mapped measure.
3) The overall performance rate of Rate 1 and Rate 2 combined
Denominator: All patients 18 years or older with shoulder, elbow, wrist/hand injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Numerator: Number of patients aged 18 years or older with shoulder, elbow, wrist/hand pain who achieve an overall score change of 2.0 points in PROMIS Pain Interference or like mapped measurement tool.
Denominator Exclusions: Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation. Patients where score change cannot be measured due to lack of 2+ completed surveys within the measurement window.
Denominator Exceptions: Physical Therapists can exclude patients based on an evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway. Patients may also be excluded if they are seen for less than 3 visits.
High Priority Measure? Yes High Priority Type: Outcome
Measure Type: Patient reported outcome based performance measure
NQS Domain: effective clinical care
Care Setting: ambulatory care: clinician office/ clinic
Includes Telehealth? Yes
Which Meaningful Measure Area applies to this measure? Functional outcomes
Percentage of patients 18 years or older suffering from a knee injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Upper Extremity Computer Adaptive Testing. The MCID for PROMIS Physical Function is unique and validated for patients suffering knee functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR1
All patients 18 years or older with a knee injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with a knee injury who achieve an overall score change of 2.1 points in PROMIS Physical Function.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from a lumbar spine (low back) injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Upper Extremity Computer Adaptive Testing. The MCID for PROMIS Physical Function is unique and validated for patients suffering low back functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR2
All patients 18 years or older with a lumbar spine (low back) injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with a lumbar spine (low back) injury who achieve an overall score change of 2.1 points in PROMIS Physical Function.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from a cervical spine (neck) injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Upper Extremity Computer Adaptive Testing. The MCID for PROMIS Physical Function is unique and validated for patients suffering neck functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR3
All patients 18 years or older with a cervical spine (neck) injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with a cervical spine (neck) injury who achieve an overall score change of 2.1 points in PROMIS Physical Function.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from a hip injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Upper Extremity Computer Adaptive Testing. The MCID for PROMIS Physical Function is unique and validated for patients suffering hip functional deficits.This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR4
All patients 18 years or older with a hip injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with a hip injury who achieve an overall score change of 2.1 points in PROMIS Physical Function.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from a shoulder injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Upper Extremity Computer Adaptive Testing. The MCID for PROMIS Upper Extremity is unique and validated for patients suffering shoulder functional deficits.This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR5
All patients 18 years or older with a shoulder injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with a shoulder injury who achieve an overall score change of 2.1 points in PROMIS Upper Extremity.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from knee injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT). The MCID for PROMIS Pain Interference is unique and validated for patients suffering knee functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR6
All patients 18 years or older with knee injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with knee injury who achieve an overall score change of 2.0 points in PROMIS Pain Interference.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from lumbar spine (low back) pain who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT). The MCID for PROMIS Pain Interference is unique and validated for patients suffering low back functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR7
All patients 18 years or older with lumbar spine (low back) pain evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with lumbar spine (low back) pain who achieve an overall score change of 2.0 points in PROMIS Pain Interference.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from cervical spine (neck) pain who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT). The MCID for PROMIS Pain Interference is unique and validated for patients suffering neck functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR8
All patients 18 years or older with cervical spine (neck) pain evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with cervical spine (neck) pain who achieve an overall score change of 2.0 points in PROMIS Pain Interference.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcome
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from hip injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT). The MCID for PROMIS Pain Interference is unique and validated for patients suffering hip functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined.To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR9
All patients 18 years or older with hip injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with hip injury who achieve an overall score change of 2.0 points in PROMIS Pain Interference.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from shoulder pain who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT). The MCID for PROMIS Pain Interference is unique and validated for patients suffering shoulder functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR10
All patients 18 years or older with shoulder pain evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with shoulder pain who achieve an overall score change of 2.0 points in PROMIS Pain Interference.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
IA_BE_6
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement, including development of improvement plan.
Beneficiary Engagement
High
IA_BE_7
Participation in a QCDR, that promotes use of patient engagement tools
Participation in a Qualified Clinical Data Registry (QCDR), that promotes patient engagement, including:
Beneficiary Engagement
Medium
IA_BE_8
Participation in a QCDR, that promotes collaborative learning network opportunities that are interactive.
Participation in a QCDR, that promotes collaborative learning network opportunities that are interactive.
Beneficiary Engagement
Medium
IA_BE_22
Improved Practices that Engage Patients Pre-Visit
Implementation of workflow changes that engage patients prior to the visit, such as a pre-visit development of a shared visit agenda with the patient, or targeted pre-visit laboratory testing that will be resulted and available to the MIPS eligible clinician to review and discuss during the patient’s appointment.
Beneficiary Engagement
Medium
IA_AHE_3
Promote Use of Patient-Reported Outcome Tools
Demonstrate performance of activities for employing patient-reported outcome (PRO) tools and corresponding collection of PRO data such as the use of PHQ-2 or PHQ-9, PROMIS instruments, patient reported Wound-Quality of Life (QoL), patient reported Wound Outcome, and patient reported Nutritional Screening.
Achieving Health Equity
High
Percentage of patients 18 years or older suffering from a knee injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Upper Extremity Computer Adaptive Testing. The MCID for PROMIS Physical Function is unique and validated for patients suffering knee functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR1
All patients 18 years or older with a knee injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with a knee injury who achieve an overall score change of 2.1 points in PROMIS Physical Function.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from a lumbar spine (low back) injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Upper Extremity Computer Adaptive Testing. The MCID for PROMIS Physical Function is unique and validated for patients suffering low back functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR2
All patients 18 years or older with a lumbar spine (low back) injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with a lumbar spine (low back) injury who achieve an overall score change of 2.1 points in PROMIS Physical Function.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from a cervical spine (neck) injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Upper Extremity Computer Adaptive Testing. The MCID for PROMIS Physical Function is unique and validated for patients suffering neck functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR3
All patients 18 years or older with a cervical spine (neck) injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with a cervical spine (neck) injury who achieve an overall score change of 2.1 points in PROMIS Physical Function.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from a hip injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Upper Extremity Computer Adaptive Testing. The MCID for PROMIS Physical Function is unique and validated for patients suffering hip functional deficits.This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR4
All patients 18 years or older with a hip injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with a hip injury who achieve an overall score change of 2.1 points in PROMIS Physical Function.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from a shoulder injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Upper Extremity Computer Adaptive Testing. The MCID for PROMIS Upper Extremity is unique and validated for patients suffering shoulder functional deficits.This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR5
All patients 18 years or older with a shoulder injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with a shoulder injury who achieve an overall score change of 2.1 points in PROMIS Upper Extremity.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from knee injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT). The MCID for PROMIS Pain Interference is unique and validated for patients suffering knee functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR6
All patients 18 years or older with knee injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with knee injury who achieve an overall score change of 2.0 points in PROMIS Pain Interference.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from lumbar spine (low back) pain who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT). The MCID for PROMIS Pain Interference is unique and validated for patients suffering low back functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR7
All patients 18 years or older with lumbar spine (low back) pain evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with lumbar spine (low back) pain who achieve an overall score change of 2.0 points in PROMIS Pain Interference.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from cervical spine (neck) pain who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT). The MCID for PROMIS Pain Interference is unique and validated for patients suffering neck functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR8
All patients 18 years or older with cervical spine (neck) pain evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with cervical spine (neck) pain who achieve an overall score change of 2.0 points in PROMIS Pain Interference.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcome
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from hip injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT). The MCID for PROMIS Pain Interference is unique and validated for patients suffering hip functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined.To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR9
All patients 18 years or older with hip injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with hip injury who achieve an overall score change of 2.0 points in PROMIS Pain Interference.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from shoulder pain who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT). The MCID for PROMIS Pain Interference is unique and validated for patients suffering shoulder functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR10
All patients 18 years or older with shoulder pain evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with shoulder pain who achieve an overall score change of 2.0 points in PROMIS Pain Interference.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
IA_BE_6
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement, including development of improvement plan.
Beneficiary Engagement
High
IA_BE_7
Participation in a QCDR, that promotes use of patient engagement tools
Participation in a Qualified Clinical Data Registry (QCDR), that promotes patient engagement, including:
Beneficiary Engagement
Medium
IA_BE_8
Participation in a QCDR, that promotes collaborative learning network opportunities that are interactive.
Participation in a QCDR, that promotes collaborative learning network opportunities that are interactive.
Beneficiary Engagement
Medium
IA_BE_22
Improved Practices that Engage Patients Pre-Visit
Implementation of workflow changes that engage patients prior to the visit, such as a pre-visit development of a shared visit agenda with the patient, or targeted pre-visit laboratory testing that will be resulted and available to the MIPS eligible clinician to review and discuss during the patient’s appointment.
Beneficiary Engagement
Medium
IA_AHE_3
Promote Use of Patient-Reported Outcome Tools
Demonstrate performance of activities for employing patient-reported outcome (PRO) tools and corresponding collection of PRO data such as the use of PHQ-2 or PHQ-9, PROMIS instruments, patient reported Wound-Quality of Life (QoL), patient reported Wound Outcome, and patient reported Nutritional Screening.
Achieving Health Equity
High
Percentage of patients 18 years or older suffering from a knee injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Upper Extremity Computer Adaptive Testing. The MCID for PROMIS Physical Function is unique and validated for patients suffering knee functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR1
All patients 18 years or older with a knee injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with a knee injury who achieve an overall score change of 2.1 points in PROMIS Physical Function.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from a lumbar spine (low back) injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Upper Extremity Computer Adaptive Testing. The MCID for PROMIS Physical Function is unique and validated for patients suffering low back functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR2
All patients 18 years or older with a lumbar spine (low back) injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with a lumbar spine (low back) injury who achieve an overall score change of 2.1 points in PROMIS Physical Function.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from a cervical spine (neck) injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Upper Extremity Computer Adaptive Testing. The MCID for PROMIS Physical Function is unique and validated for patients suffering neck functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR3
All patients 18 years or older with a cervical spine (neck) injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with a cervical spine (neck) injury who achieve an overall score change of 2.1 points in PROMIS Physical Function.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from a hip injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Upper Extremity Computer Adaptive Testing. The MCID for PROMIS Physical Function is unique and validated for patients suffering hip functional deficits.This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR4
All patients 18 years or older with a hip injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with a hip injury who achieve an overall score change of 2.1 points in PROMIS Physical Function.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from a shoulder injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Upper Extremity Computer Adaptive Testing. The MCID for PROMIS Upper Extremity is unique and validated for patients suffering shoulder functional deficits.This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR5
All patients 18 years or older with a shoulder injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with a shoulder injury who achieve an overall score change of 2.1 points in PROMIS Upper Extremity.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from knee injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT). The MCID for PROMIS Pain Interference is unique and validated for patients suffering knee functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR6
All patients 18 years or older with knee injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with knee injury who achieve an overall score change of 2.0 points in PROMIS Pain Interference.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from lumbar spine (low back) pain who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT). The MCID for PROMIS Pain Interference is unique and validated for patients suffering low back functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR7
All patients 18 years or older with lumbar spine (low back) pain evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with lumbar spine (low back) pain who achieve an overall score change of 2.0 points in PROMIS Pain Interference.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from cervical spine (neck) pain who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT). The MCID for PROMIS Pain Interference is unique and validated for patients suffering neck functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR8
All patients 18 years or older with cervical spine (neck) pain evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with cervical spine (neck) pain who achieve an overall score change of 2.0 points in PROMIS Pain Interference.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcome
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from hip injury who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT). The MCID for PROMIS Pain Interference is unique and validated for patients suffering hip functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined.To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR9
All patients 18 years or older with hip injury evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with hip injury who achieve an overall score change of 2.0 points in PROMIS Pain Interference.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
Percentage of patients 18 years or older suffering from shoulder pain who achieve the Minimal Clinically Important Difference (MCID) in the PROMIS Pain Interference Computer Adaptive Testing (CAT). The MCID for PROMIS Pain Interference is unique and validated for patients suffering shoulder functional deficits. This measure will be reported as the overall number of patients of rate 1 and rate 2 combined. To qualify, the patient must complete a baseline score and then one follow-up or discharge score.
In order to fairly measure performance between providers' performance, the measure is risk-adjusted based on a proprietary assessment including age, sex, symptom characteristics, PROMIS baseline scores, social determinants of health, and psychosocial metrics.
LMBR10
All patients 18 years or older with shoulder pain evaluated and treated by a physical therapist (PT) or physical therapy group at the beginning of the measurement period with at least one eligible follow up encounter during the measurement period.
Number of patients aged 18 years or older with shoulder pain who achieve an overall score change of 2.0 points in PROMIS Pain Interference.
Patients who are under the age of 18. Patients who are non-English speaking or/and can not read. Patients who have severe mental or cognitive deficits limiting the accuracy of their questionnaire. This will be determined by the physical therapist at the time of the evaluation.
Physical Therapists can exclude patients based on a full initial evaluation who may have severe comorbidities or demonstrate medical complexity that does not follow a standard care pathway.
None
Effective Clinical Care
Patient-Reported Outcome-based Performance Measure (PRO-PM)
No
Yes
No
No
1
Yes
Functional Outcomes
Ambulatory Care: Clinician Office/Clinic
Yes
Yes
IA_BE_6
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement, including development of improvement plan.
Beneficiary Engagement
High
IA_BE_7
Participation in a QCDR, that promotes use of patient engagement tools
Participation in a Qualified Clinical Data Registry (QCDR), that promotes patient engagement, including:
Beneficiary Engagement
Medium
IA_BE_8
Participation in a QCDR, that promotes collaborative learning network opportunities that are interactive.
Participation in a QCDR, that promotes collaborative learning network opportunities that are interactive.
Beneficiary Engagement
Medium
IA_BE_22
Improved Practices that Engage Patients Pre-Visit
Implementation of workflow changes that engage patients prior to the visit, such as a pre-visit development of a shared visit agenda with the patient, or targeted pre-visit laboratory testing that will be resulted and available to the MIPS eligible clinician to review and discuss during the patient’s appointment.
Beneficiary Engagement
Medium
IA_AHE_3
Promote Use of Patient-Reported Outcome Tools
Demonstrate performance of activities for employing patient-reported outcome (PRO) tools and corresponding collection of PRO data such as the use of PHQ-2 or PHQ-9, PROMIS instruments, patient reported Wound-Quality of Life (QoL), patient reported Wound Outcome, and patient reported Nutritional Screening.
Achieving Health Equity
High
