Patient Reported Falls and Plan of Care

Measure Specification

Many studies have been conducted on the rate of falls for common neurological conditions. All of them indicate that falls are an issue for neurology patients with symptomology that affects movement and balance. Falls and the fear of falling can impact quality of life and should be addressed for populations most at risk for falling. In people age 65 years and older, falls are one of the leading causes of death.

However, patients with neurological conditions are often younger and are at an increased risk for falls due to disease symptomology. 127,456,106 non-fatal falls were recorded from 2001-2015. For those that were hospitalized due to the fall, the cost is approximately $39,000 per patient. The U.S. Preventive Services Task Force updated their recommendations for fall prevention in community-dwelling older adults.

There are many intervention recommendations for patients 65 years and older.

• The USPSTF recommends exercise interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls (B recommendation) • The USPSTF recommends that clinicians selectively offer multifactorial interventions to prevent falls to community-dwelling adults 65 years or older who are at increased risk for falls.

Existing evidence indicates that the overall net benefit of routinely offering multifactorial interventions to prevent falls is small.

This measure contains two strata defined by two submission criteria. This measure produces two performance rates. There are 2 Submission Criteria for this measure: 1) Patients with an active diagnosis of a movement disorder, multiple sclerosis, a neuromuscular disorder, dementia, or stroke. AND 2) Patients with an active diagnosis of a movement disorder, multiple sclerosis, a neuromuscular disorder, dementia, or stroke who report (or caregiver as appropriate) a fall occurred since last visit.

Submission Criteria 1 ensures the full patient population is being assessed and reporting requirements are met. This measure will be calculated with 2 performance rates: 1) Patients with a diagnosis of a movement disorder, multiple sclerosis, a neuromuscular disorder, dementia, or stroke who were assessed for at each visit during the performance period 2) Patients with a diagnosis of a movement disorder, multiple sclerosis, a neuromuscular disorder, dementia, or stroke who report a fall occurred since the last visit AND who have a plan of care for falls For accountability reporting in the CMS MIPS program, the rate for Submission Criteria 2 is used for performance.

For the purposes of data completeness, Submission Criteria 1 will be used. For the purposes of MIPS implementation, this visit measure is submitted each time a patient has a denominator eligible encounter during the performance period.