Contraceptive Use eCQMs, Postpartum

Eligibility inclusion criteria: All women 15 – 44 years old eligible for postpartum contraception during the measurement period, who answered yes to SINC or were not asked it. This is defined as those who had a live birth in the 12 months starting 3 months prior to the beginning of the  measurement year to 9 months into the measurement year.

Level of analysis: This measure can be calculated and analyzed at both the clinician group/practice level and the facility level. 

Measurement period: The measurement period is fifteen months: 3 months prior to the calendar year (i.e., 10/1/XX-1) through the end of the calendar year (i.e., 12/31/XX). This measure is calculated using two consecutive calendar years of data: the year prior to the measurement period, and the measurement period, in order to better capture inclusion and exclusion information. 

• The denominator for the CU-SINC primary and LARC-SINC submeasure are the same.
• The measurement period is 15 months: three months prior to the calendar year (i.e., 10/1/XX-1) through the end of the calendar year (i.e., 12/31/XX). For example, if the calendar year is 2023, then the measurement period for CU-SINC, Postpartum is 10/1/2022 through 12/31/2023.
• The measure denominator includes patients who meet the following criteria:
  • Assigned female at birth aged 15-44 years and had a qualifying encounter (see VSAC for full list of qualifying encounter types) from three months prior to the start of the calendar year through the end of the calendar year (i.e., 10/1/XX-1 through 12/31/XX). Age is calculated with the start of the calendar year as an anchor date;
  • Had a live birth making them eligible for postpartum contraception: Those who had a prenatal care visit in the year prior to the calendar year through the first nine months of the calendar year (i.e., 1/1/XX-1 through 9/30/XX) with a documented live birth delivery date or a documented EDD between three months prior to the calendar year and nine months into the calendar year (i.e., 10/1/XX-1 through 9/30/XX).
  • Patients are excluded from the denominator if:
    • They were documented to have not had a live birth, including those with ectopic pregnancies, intrauterine fetal demise, early pregnancy loss, or abortion
    • They did not want to discuss their contraceptive needs (SINC) and were not provided nor were documented to be using a most or moderately effective contraceptive method throughout the postpartum period (i.e., within 90 days after live birth delivery).

• The numerator of the primary measure (CU-SINC) includes patients in the denominator who were provided or were documented to be using a most (i.e., sterilization, implants, intrauterine devices or systems) or moderately effective (i.e., injectables, oral pills, patch, or ring) method within 90 days after delivery. If a live birth date is documented, provision or documentation of method use must occur in a visit within 90 days after this date. As some health care systems provide peripartum care, but not the delivery care itself, the live birth date is not consistently documented. The measure specifications therefore include using the estimated delivery date (EDD) when live birth data is not available In this case, the visit in which contraception was provided or documented must occur after 24 weeks of pregnancy as determined by the estimated delivery date (EDD), and within 90 days after the EDD.
• The numerator of the LARC-SINC submeasure includes patients in the denominator who were provided a LARC (i.e., IUD or implant) within 90 days after live birth delivery date. If a live birth date is documented, provision of the method must occur in a visit within 90 days after this date. If no live birth date is documented, method use or provision then the visit in which contraception was provided or documented must occur after 24 weeks of pregnancy as determined by the EDD and within 90 days after the EDD.

Codebook for CU-SINC measures, Postpartum (VSAC) coming soon

Quick start guide coming soon

Inclusion Flow Diagram, CU-SINC, Postpartum