2022 HM9: Functional Benefit of a Cochlear Implant

Measure Description

Percentage of patients aged 18 years and older, who are evaluated for hearing loss and complete a hearing loss self-assessment tool that indicated an impact of hearing-related quality of life (QoL), and if diagnosed with a bilateral moderate to profound sensorineural hearing loss (SNHL) and less than 60% open set speech recognition are scheduled or referred for cochlear implant candidacy testing AND for patients who undergo cochlear implantation, demonstrate a meaningful clinically important difference (MCID) improvement in self-assessment of Hearing-related QoL or an improvement in speech recognition within 18 months of cochlear implant activation.

Denominator

Strata 1: Patients aged 18 years and a patient encounter

Strata 2: Patients aged 18 years and older who are diagnosed with a bilateral moderate to profound SNHL that impacts their quality of life, and less than 60% open set speech recognition, are scheduled or referred for cochlear implant candidacy testing

Numerator

Strata 1: if diagnosed with a bilateral moderate to profound SNHL , and less than 60% open set speech recognition are scheduled or referred for cochlear implant candidacy testing.

OR

Patient completed a self-assessment tool that indicated an impact of hearing QoL, received a hearing loss assessment procedure, was diagnosed with bilateral moderate to profound SNHL and less than 60% open set speech recognition, and was referred to another provider for cochlear implant candidacy testing.

OR

Patient completed a self-assessment tool that indicated an impact of hearing QoL, received a hearing loss assessment procedure and was diagnosed with hearing loss not within cochlear implant testing candidacy criteria
Strata 2: Patient demonstrates a MCID improvement in self-assessment of Hearing-related QoL AND an improvement in speech recognition within 18 months of cochlear implant activation

OR

Patient demonstrates a MCID improvement in self-assessment of Hearing-related QoL but does not demonstrate an improvement in speech recognition within 18 months of cochlear implant activation.

OR

Patient demonstrates an improvement in speech recognition but does not demonstrate a MCID improvement in self-assessment of Hearing-related QoL within 18 months of cochlear implant activation.

Denominator Exclusions

Patients unable to complete a hearing loss self-assessment tool or equivalent instrument due to severe cognitive deficit or mental incapacity

OR

Patients with language incompatibility to available hearing loss self-assessment tool proxy

OR

Patients with partial or complete external ear canal obstruction from cerumen inhibiting the ability to complete a hearing evaluation

OR

Patients with partial or complete foreign body obstruction inhibiting the ability to complete a hearing evaluation

Denominator Exceptions

Strata 1: Patient completed a hearing self-assessment tool that indicated an impact of hearing QoL received a hearing loss assessment procedure, was diagnosed with bilateral moderate to profound SNHL and less than 60% open set speech recognition with documented medical/patient reason(s) the patient’s cochlear implant candidacy testing was not scheduled or referred for cochlear implant candidacy testing.

OR

Patient completed a self-assessment tool that indicated an impact of hearing QoL, received a hearing loss assessment procedure, was diagnosed with bilateral moderate to profound SNHL and less than 60% open set speech recognition but has not yet had a trial with amplification so was not scheduled or referred for cochlear implant candidacy testing.

Strata 2: Patient declined or is unable to complete post-cochlear implant self-assessment tool, medical/patient/system reason provided within 18 months of cochlear implant activation.

Numerator Exclusions

N/A

NQF ID Number

N/A

NQS Domain

Effective Clinical Care

High Priority Measure

Yes

Measure Type

Patient Reported Outcome (PRO)

Includes Telehealth?

Yes

Inverse Measure

No

Proportional Measure

Yes

Continuous Variable Measure

No

Ratio Measure

No

Number of performance rates to be calculated and submitted

2

Risk-Adjusted Status?

No