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Measure 226


Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Description: The percentage of adult patients who were screened for tobacco use and who received tobacco cessation intervention if identified as a tobacco user.

Measure ID: 226

Type: Process

CMS Derm Specialty Set: Yes

High priority: No

Topped out: No

Reporting methods: Registry/QCDR, EHR, or Claims

Maximum points: 3

Measure purpose: This measure is intended to promote adult tobacco screening and tobacco cessation interventions. Research shows that tobacco screening and brief cessation intervention is successful in helping tobacco users quit. Tobacco users who are able to stop using tobacco lower their risk for heart disease, lung disease, stroke, and other associated outcomes.

Calculation

Physicians must report on three distinct sets of numerators and denominators to satisfy reporting requirements for this measure. 

Criteria 1
The numerator: The number of adult patients who were screened for tobacco use.

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The denominator: All adult patients seen for at least two visits or at least one preventive visit during the reporting period.

Criteria 2
The numerator: The number of patients who received tobacco cessation intervention.

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The denominator: All adult patients who were screened for tobacco use and identified as a tobacco user.

Criteria 3
The numerator: The number of adult patients who were screened for tobacco use and received tobacco cessation intervention.

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The denominator: All adult patients seen for at least two visits or at least one preventive visit during the reporting period.

Click on the image to download PDF.

Measure calculation example

Dr. Laurent saw 181 adult patients on at least two visits or one preventative visit during the reporting period. None of these patient encounters can be excluded, so the denominator for Criteria 1 is 181.

Dr. Laurent screened 152 of these patients for tobacco use. This is the numerator for Criteria 1. Quality of patient care = 152/181. Dr. Laurent has a score of 84% for Criteria 1.

Of the 152 patients Dr. Laurent screened for tobacco use, 37 indicated tobacco use. This is the denominator for Criteria 2. Quality of patient care = 36/37. Dr. Laurent has a score of 93.3% for Criteria 2.

For Criteria 3, the denominator is 181. The numerator is 36. Quality of patient care = 36/181. Dr. Laurent has a score of 19.9% for Criteria 3.

Her reporting on these three criteria earns Dr. Laurent 3 points.

Important note

CMS has not set benchmarks for this measure because measure reporting for 2019 cannot be compared to previous years. As a result, successfully reporting the three criteria on even only one patient will earn the physician three points, regardless of criteria performance scores. A physician such as Dr. Laurent, who achieves high performance scores — she screens most of her patients and offers tobacco cessation intervention to nearly all identified smokers — still earns only 3 points.

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