All pregnant and postpartum patients are to be systematically assessed for cardiovascular disease (CVD). UCI implemented and tested a standardized CVD risk assessment algorithm that can be integrated into any EHR system, providing an immediate triage of patients at low and high risk for CVD. Once identified as being at risk for CVD, follow-up cardiac tests, including EKG and ECHO, and consultations are scheduled as necessary.
The UCI team has developed a national quality measure titled “CVD Risk Assessment Measure- Proportion of pregnant/postpartum patients who receive CVD Risk Assessment with a standardized tool” (Quality ID 2022-048). The quality measure was presented to the Centers for Medicare and Medicaid Services as Measures under Consideration (MUC) in April 2022, applied for endorsement through the National Quality Forum (NQF) in August 2022, and was added to the Merit Payment Incentive System by the Centers for Medicaid and Medicare Services for years 2022-2023.
Measure Information
The measure excludes patients with a preexisting heart problem, and patients who have another reason for visiting a clinic [not prenatal or postpartum care] and have a positive pregnancy test but plan to terminate the pregnancy or seek prenatal services elsewhere.
This measure determines the percentage of pregnant or postpartum patients at a clinic who were assessed for CVD risk with a standardized tool, such as the CVD risk assessment algorithm developed by the California Maternal Quality Care Collaborative (CMQCC). The aim is to perform a CVD risk assessment using a standardized tool on all (100 %) eligible pregnant/postpartum patients. Every single patient should be assessed for CVD risk at least once during their pregnancy and, if needed, additional times when new symptoms present during the pregnancy and/or postpartum period. A threshold has still to be determined (“at least xxx % of patients who received risk assessment”). The measure can be calculated on a quarterly or annual basis.