91

HIV: Viral Load Suppression

Percentage of patients, regardless of age, with a diagnosis of HIV with a HIV viral load less than 200 copies/mL at last HIV viral load test during the measurement year.  A medical visit is any visit in an outpatient/ambulatory care setting with a nurse practitioner, physician, and/or a physician assistant who provides comprehensive HIV care.  

Date Reviewed: November 4, 2018
Support
    Facility Group/Practice Individual Clinician

Measure Info

MIPS 338 NQF 2082, 3210e CMS 338 NQF Endorsed
Measure Type
Outcome
Measure Steward
Health Resources Services Administration
Clinical Topic Area
HIV
Care Setting
Outpatient
Data Source
Paper Medical Records
Registry

91 supports MIPS measure ID# 338 (NQF ID# 2082): “HIV: Viral Load Suppression” because implementation will likely lead to measureable and meaningful improvements in clinical outcomes, the target viral load of <200 copies/mL is reasonable and appropriate, developers cite clinical recommendations of the National Institute of Health (NIH) and the World Health Organization (WHO) to form the basis of the measure, and the data presented in the measure background materials supports reliability at the level of the individual clinician. While we support this measure, we suggest that developers revise the specifications to include some element of risk adjustment. The disparities data presented in the background materials states that ~30% of patients who are living with HIV are not covered by insurance. Therefore, the specifications should include exclusion criteria for patient refusal.