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2.15.2018 Transitions of Care A member is admitted to the hospital on December 30, 2016, and discharged in January 2017. To meet criteria, the Notification of Inpatient Admission must occur on either December 30 or 31, 2016, but the measure description states that the four elements must occur during the measurement year. Can we count the Notification of Inpatient Admission that occurs in the year prior to the measurement year?

Yes. In the scenario above, Notification of Inpatient Admission may be on the admission date or on the following date, even if it occurs in the year prior to the measurement year. The member in this example remains in the measure because the discharge date was in January 2017. Unless the patient’s PCP or ongoing care provider was involved in the patient’s care prior to the admission (e.g., conducted the patient’s pre-admission exam), a communication on the admission date or the date following meets criteria for the Notification of Inpatient Admission numerator.

HEDIS 2018