CMS measures to start adjusting for stroke severity in 2016

Upcoming coding will allow the Centers for Medicare & Medicaid Services (CMS) to adjust for stroke severity in quality measures, the American Stroke Association’s council reported in its spring update. It was one of several highlights that the council described as sea changes.

Currently, the quality measures used by CMS for 30-day mortality and 30-day readmission rates after ischemic stroke do not account for baseline stroke severity. The writing team led by Joseph P. Broderick, MD, of the University of Cincinnati Neuroscience Institute, noted that this model may unfairly characterize primary and comprehensive stroke centers in urban settings whose patient populations typically experience the most severe types of stroke.    

The Tenth Revision Clinical Modification codes will include codes for the National Institutes of Health Stroke Scale starting in 2016, giving CMS the ability to adjust for stroke severity in its assessment of hospitals. “While it will take several years beyond 2016 for the data to be used by CMS in reporting hospital mortality and readmission rates, it will result in much more accurate measurements and comparisons of hospital outcomes,” they wrote.

Other updates included:

  • Stroke dropped from being the third leading cause of death in the U.S. in 2011 to fourth place, and further dropped to fifth place by December of that year.
  • A partnership of Get with the Guidelines and the Joint Commission on Accreditation of Healthcare Organizations led to a third tier in the stroke system care, adding stroke-ready hospitals to the list this spring.
  • The 2015 International Stroke Conference chalked up its highest attendance ever, with 4,341 attendees.
  • The association is working to update its Stroke Advisory for Acute Ischemic Stroke to incorporate late-breaking clinical trial results on endovascular therapies.

The update was published online April 2 in Stroke.