QCDR measure AAD 20
Actinic Keratosis: Self-reported AK Treatment or Management Outcomes
DESCRIPTION:
Percentage of adult patients (18 years old and older) who self-report favorable outcomes resulting from a recommended treatment or management approach for Actinic Keratosis (AK) and who self-report satisfaction with the treatment or management of AK. Patients provide a global assessment of the perceived effectiveness of the AK treatment or management plan, followed by their satisfaction and future treatment preference. Evaluating both treatment effectiveness and patient satisfaction supports patient–provider communication and promotes patient-centered approaches to AK care.
| MEASURE ID: | AAD20 |
|---|---|
| Type: | Patient Reported Outcome-Based Performance Measure (PRO-PM) |
CMS Derm Specialty Set: | N/A |
| High priority: | Yes |
| Topped out: | No |
| Telehealth Eligible: | No |
| Reporting methods: | Registry/QCDR |
| Maximum points: | 10 |
MEASURE PURPOSE:
Patient perceptions of treatment and/or management approaches may significantly affect treatment choice and adherence that facilitate patient-centered approaches to care. Evaluating patient’s perceptions of treatment effectiveness may help healthcare providers more effectively tailor care based on the patient’s medical needs and personal preferences.
AAD20 FAQs
Q. Is this measure reportable via claims?
A. No. This measure can only be reported via a registry, such as DataDerm.
Q. Are patient encounters conducted via telehealth allowable?
A. No. Telehealth encounters are not allowable.
Q. What is the numerator?
A. Adult patients (≥18 years old) who self-reported perceived outcomes resulting from the treatment or management approaches used to address their diagnosed AK and satisfaction with their care, using three five-item Likert-type scale questions. All three questions must be answered. The composite score is calculated as the unweighted average of the three responses. A score of ≥ 4.0 indicates a favorable perception of the treatment or management approach, including both effectiveness and satisfaction.
Q. What is the denominator?
A. The denominator includes all adult patients (>18 years of age) who have an encounter during the performance period and a diagnosis of Actinic Keratosis (L57.0). Eligible CPT codes for encounters include 99211-99215, 17000, 17003, 17004, 96567, 96573, and 96574. The encounter must also be within 12 months prior to the performance period.
Q. Are there any exclusions for this measure?
A. Yes. Patients with severe mental and/or physical incapacity that prevents them from answering the self-report questions are excluded.
Q. Are there any exceptions for this measure?
A. No, there are no exceptions.
Q. Is this an inverse measure?
A. No. This is not an inverse measure.
Q. How is the numerator data collected?
A. Using the following three five-item Likert-type scale questions:
Question 1: How would you rate your AKs now compared to before treatment? 1 = Much Worse 2 = Somewhat Worse 3 = Stayed the Same 4 = Somewhat Better 5 = Much Better
Question 2: How would you rate your ability to follow the management plan? 1 = Very Poor 2 = Poor 3 = Fair 4 = Good 5 = Very Good
Question 3: If you have to care for your AKs again in the future, how likely would you be to use the same approach? 1 = Extremely Unlikely 2 = Unlikely 3 = Neutral 4 = Likely 5 = Extremely Likely
Threshold for Positive Response: All three questions must be answered. The composite score is calculated as the unweighted average of the three responses. Patients are counted in the numerator if:
Composite Score = Q1 + Q2 + Q3 ÷ 3 = ≥ 4.0
A score of ≥ 4.0 indicates a favorable perception of the treatment or management approach, including both effectiveness and satisfaction.
Q. Can this measure be reported by a dermatologist who treats actinic keratosis?
A. Yes, any dermatologist who treats AK and engages in management or treatment plans can report this measure, if the required patient demographics and performance criteria are met.
Q. What are the treatment outcomes being assessed?
A. The treatment outcomes are patients’ self-reported perceptions regarding the effectiveness of their AK treatment or management plan, which may include active treatment or surveillance without treatment.
Calculation
The numerator: Adult patients (18 years old and older) who self-reported perceived outcomes resulting from the treatment or management approaches used to address their diagnosed AK and satisfaction with their care, using three five-item Likert-type scale questions. All three questions must be answered. The composite score is calculated as the unweighted average of the three responses. A score of 4.0 and greater indicates a favorable perception of the treatment or management approach, including both effectiveness and satisfaction.
The denominator: All adult patients, aged 18 years and older who had a visit during the performance period AND had a visit during the 12 months prior to the performance period with a diagnosis of AK.
Measure calculation example
Dr. Morrison saw 211 adult patients who had visited in the previous 12 months with a diagnosis of AK. The denominator is 211.
Of these patients, 141 completed all 3 questions of the treatment effectiveness and care satisfaction scale and scored 4 or greater.
Quality of patient care = 141/211. Dr. Morrison has a score of 66.8% for this measure. This translates to a minimum of 5 points.
Important note
This measure has no benchmarks. Since it is a newer measure in its second year in the program, if the clinician meets data completeness, they earn a minimum of 5 points, upwards of 10 points.
