Cardio Milestone 4

To achieve Cardio Milestone 4, home health agencies must complete the following:
  1. Cardio Milestone 4 iconAchieve Cardio Milestone 3.
  1. Enter & close a total of six months of required patients' data in the Home Health Cardiovascular Data Registry (HHCDR).
  1. Assess data reliability. Read more about the Assessment of Data Reliability (ADR) process below or submit an ADR request form now.
YOU'RE ALMOST THERE! See what it takes to achieve Cardio Milestone 5.

HHCDR Assessment of Data Reliability (ADR)

Purpose: This activity is designed to assist home health agencies in ensuring they are collecting reliable data to use in their quality improvement efforts.  This information will be shared with no one other than the requesting home health agency.

If you choose to participate in this free assessment, a random selection of your HHA’s HHCDR entries will be re-abstracted by Quality Insights, the Medicare Quality Innovation Network-Quality Improvement Organization (QIN-QIO) contracted by the Centers for Medicare & Medicaid Services (CMS) to facilitate the Home Health Cardiovascular Data Registry and execute the HHQI National Campaign. 

Upon completion of the reliability assessment, your HHA will receive a crude agreement report based upon the chart below. Those receiving an ‘Acceptable’ Agreement Category will achieve Cardio Milestone 4.

Agreement Category


(overall crude agreement rate)

Acceptable 85% - 100%
Fair 70% - 84%
Poor 55% - 69%
Unacceptable <55%

Please note that this process does not represent an audit. Under law, Quality Insights may only provide aggregate information to CMS, and may not disclose your home health agency’s identity without your consent.

HHCDR Data Reliability Assessment Process Flow:
  1. Eligible topic area(s) for data reliability assessment include: Aspirin, Blood pressure, Cholesterol, and/or Smoking with at least six (6) months of HHCDR data entry.
  2. To initiate the process, please complete the ADR form located here
  3. We will provide your designated contact a list of a maximum of thirty (30) records to be included in the assessment process within three (3) weeks.
  4. You will receive information on uploading your records to our secure-file website.  We CANNOT accept paper copies due to our security policies.   All copies of electronic documents received will be destroyed appropriately upon process completion.
  5. Our abstractors will perform blind abstraction of the provided records within eight (8) weeks of record receipt.
  6. Our data analysts will perform a comparison analysis between your HHCDR data entries and our blind abstraction data entries within eight (8) weeks of abstraction completion to calculate overall crude agreement rates.
  7. Upon completion of the process, we will provide you with a detailed report with the results of the reliability assessment.

Additional Information:
  • HHQI Abstractors are registered nurses employed by Quality Insights, a Medicare Quality Innovation Network-Quality Improvement Organization (QIN-QIO) contracted by the Centers for Medicare & Medicaid Services (CMS) to provide services for the Home Health Quality Improvement (HHQI) National Campaign. 
  • These services include supporting the HHQI National Campaign Data Access System which receives Protected Health Information (PHI) from CMS.
  • As a QIN-QIO, Quality Insights functions as a HIPAA “Business Associate” to CMS and, as such, provides satisfactory assurances to CMS regarding the confidentiality, integrity, and availability of the PHI it receives from CMS. It is under this framework, with CMS as the Covered Entity and Quality Insights as CMS’s Business Associate, that Quality Insights is obligated to protect the privacy and security of PHI maintained by Quality Insights for the HHQI National Campaign.
  • In its performance of QIN-QIO activities on behalf of CMS, Quality Insights is NOT a Business Associate of, and does not require a Business Associate Agreement with home health agencies.
  • Additional HHCDR resources can be found here: