Measure 498
Connection to Community Service Provider
DESCRIPTION:
Percent of patients 18 years and older who screened positive for one or more of the following health-related social needs: food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety and had contact with a Community Service Provider for at least one of their needs within 60 days after screening.
| MEASURE ID: | 498 |
|---|---|
| Type: | Process |
CMS Derm Specialty Set: | Yes |
| High priority: | Yes |
| Topped out: | No |
| Telehealth Eligible: | Yes |
| Reporting methods: | Registry/QCDR |
| Maximum points: | 10 |
MEASURE PURPOSE:
Increasing the implementation of SDOH screening measures to recognize risk factors associated with poorer health outcomes and address SDOH across sectors and in communities.
Measure 498 FAQs
Q. Is this measure reportable via claims?
A. No.
Q. Are patient encounters conducted via telehealth allowable?
A. Yes. Encounters coded with GQ, GT, POS 02, or POS 10 modifiers are allowable.
Q. What is the numerator?
A. Number of patients who had contact with a CSP for at least one of the following health-related social needs (HRSN): food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety within 60 days after screening.
Q. What is the denominator?
A. Number of patients 18 years and older who screened positive for at least one of the five HRSN domains.
Q. Are there any exceptions for this measure?
A. No.
Q. How often must the HRSN screening be administered?
A. The patient is required to have a standardized health-related social needs (HRSN) screening done once per performance period.
Q. Which Health-Related Social Needs screening tools can be used?
A. HRSN screening tools include but are not limited to:
Accountable Health Communities Health-Related Social Needs Screening Tool (2017)
Accountable Health Communities Health-Related Social Needs Screening Tool (2021)
The Protocol for Responding to and Assessing Patients’ Risks and Experiences (PRAPARE) Tool (2016)
WellRx Questionnaire (2014)
American Academy of Family Physicians (AAFP) Screening Tool (2018)
Calculation
The numerator: Patients who had contact with a CSP for at least one of their HRSNs within 60 days after screening.
The denominator: All patients aged 18 years and older who screened positive for at least one of five HRSN domains.
Measure calculation example
Dr. Ali saw 247 patients 18 years and older. Two hundred forty-seven (247) is the denominator.
A total of 239 patients were screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety and had contact with Community Service Provider for at least one of their HRSNs. Two hundred and thirty-nine (239) is the numerator.
Quality of patient care = 239/247. Dr. Ali has a score of 96.8% for this measure. This translates to 5-10 points.
Important note
CMS has not set benchmarks for this measure. This measure was added for 2024 and is subject to a 5-point scoring floor if data is completeness is met.
