D.C. Mun. Regs. r. 29-4514
Each FQHC shall report to DHCF, annually, on the following two (2) measure sets:
FQHC Performance Measures | ||||
Measure Number/ Name | Measurement Domain | NQF # | Steward | Description |
1. Extended After Hours | Patient-Centered Access | N/A | DHCF | FQHC offers extended hours beyond the traditional 8am-5pm business hours. |
2. 24/7 Access Policy | Patient-Centered Access | N/A | DHCF | Make access to care available 24/7. At a minimum, 24/7 access includes the availability of clinical services and advice at times that assure accessibility and meet the needs of the population to be served, and access to clinical telephonic advice when the FQHC is closed. When the FQHC is closed, 24/7 access includes the provision of telephone access to an individual with qualification and training (consistent with licensing requirements in the District) to exercise professional judgment in assessing a FQHC patient's need for emergency medical care, and the ability to direct a patient on how to seek emergency care. A patient's need for emergency care might arise from an emergent physical, oral, behavioral and/or other health need. If the patient's needs are not immediate, the individual responding to the patient via the FQHC's telephone access line shall also have the capacity to refer patients to a physician or to a licensed or certified independent practitioner that delivers health care services within the FQHC or outside the FQHC, if needed, for further assessment and future care. |
3. Adults' Access to Preventive/ Ambulatory Health Services | Patient-Centered Access | N/A | NCQA | The percentage of members twenty (20) years and older who had an ambulatory or preventive care visit. Numerator: Number of ambulatory or preventive care visits during the measurement year Denominator: Members age twenty (20) years and older as of December 31 of the measurement year |
4. Follow-up After Hospital Discharge | Transitions of Care | N/A | Minnesota Community Measurement | Percentage of patients with selected clinical conditions (heart failure, pneumonia, ischemic vascular disease and Chronic obstructive pulmonary disease) that have follow-up telephonic/ electronic contact from the FQHC within three (3) calendar days of discharge or a follow-up face-to-face visit with a health care provider (physician, physician assistant, nurse practitioner, nurse, care-coordinator) within seven (7) calendar days of hospital discharge. |
5. Follow-up After Hospitalization for Mental Illness | Transitions of Care | 0576 | NCQA | For discharges of patients age six (6 ) and older who were hospitalized for treatment of selected mental health disorders, the percentage that had an outpatient visit, an intensive outpatient encounter, or partial hospitalization with a mental health practitioner. Two rates are reported: * The percentage of discharges for which the patient received follow-up within thirty (30) calendar days of discharge. * The percentage of discharges for which the patient received follow-up within seven (7) calendar days of discharge. |
6. Timely Transmission of Transition Record | Transitions of Care | 0648 | American Medical Association-Physician Consortium for Performance Improvement | The percentage of patients, regardless of age, discharged from an inpatient facility (e.g., hospital inpatient or observation, skilled nursing facility, or rehabilitation facility) to their home or any other site of care for whom a transition record was transmitted to the facility or primary physician or other health care professional designated for follow-up care within twenty-four (24) hours of discharge. |
7. Plan All-Cause Readmission | Utilization | 1768 | NCQA | For FQHC patients eighteen (18) years of age and older, the number of acute inpatient stays during the measurement year that were followed by an acute readmission for any diagnosis within thirty (30) calendar days and the predicted probability of an acute readmission. Data is reported in the following categories: 1. Count of Index Hospital Stays (denominator) 2. Count of thirty (30)-Day Readmissions (numerator) 3. Average adjusted Probability of Readmission |
8. Potentially Preventable Hospitalization | Utilization | N/A | AHRQ | Percentage of inpatient admissions among FQHC participants for specific ambulatory care conditions that may have been prevented through appropriate outpatient care. |
9. Low-Acuity Non-Emergent Emergency Department Visits | Utilization | N/A | DHCF | Percentage of avoidable low-acuity non-emergent ED visits. |
DHCF will notify FQHCs of the performance measures, measure specifications, and any changes through transmittals issued to the FQHCs no later than ninety (90) calendar days prior to October 1st each year.
The measurement year for measures outlined in Subsection 4514.1(b) shall begin October 1, 2017 of and end on September 30, 2018, repeating annually, unless otherwise specified by DHCF.
For measures described in Subsection 4514.1(a), each FQHC shall submit measures to DHCF once HRSA has approved the FQHC's final report. The final report must be sent to DHCF no later than September 1st of each year, beginning September 1, 2017.
D.C. Mun. Regs. r. 29-4514