IT-10.1.g: Missoula-VITAS Quality of Life Index (MVQOLI-15)

Tool Title / Missoula-VITAS Quality of Life Index
Description / The Missoula-VITAS Quality of Life Index (MVQOLI) 15 item version is an assessment instrument that gathers patient-reported information about quality of life during advanced illness.
The MVQOLI asks patients about 5 dimensions or domains of quality of life: symptoms; function; interpersonal; well-being; and transcendence.
The MVQOLI is appropriate for palliative care and hospice patients (18 years or older) in a variety of settings including hospice, hospital, home health, long-term care (including assisted living), outpatient palliative care, and pre-hospice programs. It is appropriate for any patient population facing advanced, chronic, progressive illness.
Setting / Multiple
NQF Number / none
Tool Developer / VITAS Healthcare Corporation
Link to tool specifications /
Link to survey /
Measure type / Standalone
Measure status / P4P
Administration: / In routine practice, the first MVQOLI should be administered (by a MVQOLI-trained healthcare professional) as soon after admission as is practical for staff and the patient. The MVQOLI is meant to be administered several times over a patient’s course of care, the first administration serves as a baseline measure and is most accurate for that use when administered close to admission.
Ideally, the patient will agree to complete the instrument on their own (which is the preferred method), and the clinician will give them some time to do so while completing paperwork or making phone calls in another room. If they agree to complete it on their own and the clinician cannot wait, arrange for the completed MVQOLI to be picked up by the next team member to visit. In many cases, the patient will ask to have the questions read and the clinician will administer the MVQOLI as an “interview”.
Any member of the clinical team who has been trained to administer the MVQOLI could do so. In practice, clinicians report that home health aides often report being uncomfortable dealing with the issues in the MVQOLI. We also feel that volunteers, unless they are healthcare professionals, could not bring necessary clinical expertise to administration of the MVQOLI.
In determining who will administer the tool, consider the fact that most patients will want to discuss their answers. Recent studies on implementation have suggested that psychosocial staff are most interested in using the MVQOLI and may have more time to do so than nursing staff. In addition, they may be uniquely qualified to deal with some of the issues that patients want to discuss.
In order to make administration manageable for the clinical staff, it is best to do it as part of a regular visit. In some cases, the MVQOLI may serve as a reason for a visit by psychosocial staff even for patients who have declined to see a social worker or chaplain.
Mode:Patient self-report, or clinician interview
Administration Time:10-15 minutes
Language: English, Spanish, Greek
Cost:Free; registration required at
Scoring / The MVQOLI items are scored as follows:
Assessment / -2 to +2
Satisfaction / -4 to +4
Importance / 1 to 5
(Assessment + Satisfaction) X Importance =
QOL in each dimension
Note that the assessment and satisfaction scores can range from -6 to +6 and indicate whether the patient assess his/her situation positively or negatively. When multiplied by the importance factor, the overall dimension score is magnified by how important that domain is.
The final score in each dimension reflects the overall impact of that domain on quality of life.
  • Negative dimensions are reducing quality of life
  • Positive dimensions are increasing quality of life
  • The size of each dimension reflects the amount of impact
For DSRIP reporting purposes, the final scores for each dimension should be added together to create an "overall score." Note that the "overall score" can be negative, with a max score of 150 and a minimum of -150 with higher scores indicating a higher quality of life.
Contacts / Ira Byock, M.D.
The Palliative Care Service, Missoula, MT
PH: 406-728-8643 FAX: 406-728-4709
E-mail:
Contact: Melanie Merriman, Ph.D., M.B.A.
PH: 305-762-7966 FAX: 305-762-7191
E-mail:
VITAS Healthcare Corporation
PH: 305-374-4143
DSRIP-specific modifications to Measure Steward’s specification / For DSRIP reporting purposes, the five primary dimensions have been combined to create a single "overall score."
Numerator Description / The sum of "overall scores" from all of MVQOL questionnaires completed during the measurement period.
Numerator Inclusions / If a patient received the MVQOL multiple times during the measurement period, each "overall score" should be included in the numerator.
Numerator Exclusions / The survey developer does not identify specific numerator inclusions beyond what is described in the numerator description.
Denominator Description / The total number of MVQOL questionnaires completed during the measurement period.
Denominator Inclusions / If a patient received the MVQOL multiple times during the measurement period, each completed MVQOL should be included in the denominator.
Denominator Exclusions / Patients with dementia or cognitive impairments that cast doubt on the reliability of their responses are best excluded.
Patients for whom clinicians feel the MVQOLI might exacerbate their symptoms should be excluded.
Denominator Size / Providers must report a minimum of 30 cases per measure during a 12-month measurement period (15 cases for a 6-month measurement period)
  • For a measurement period (either 6 or 12-months) where the denominator size is less than or equal to 75, providers must report on all cases. No sampling is allowed.
  • For a measurement period (either 6 or 12-months) where the denominator size is less than or equal to 380 but greater than 75, providers must report on a random sample of not less than 76 cases.
  • For a measurement period (either 6 or 12-months) where the denominator size is greater than 380, providers must report on a random sample of cases that is not less than 20% of all cases; however, providers may cap the total sample size at 300 cases.

Denominator Sub-set Definition (Optional) / Providers have the option to further narrow the denominator population for this measure across one or more of the following domains. If providers wish to use this option, they must indicate their preference to HHSC through the measure selection process.
Payer: Providers may define the denominator population such that it is limited to one of the following options:
  1. Medicaid
  2. Uninsured/Indigent
  3. Both: Medicaid and Uninsured/Indigent
Gender: Providers may define the denominator population such that it is limited to one of the following options:
  1. Male
  2. Female
Ethnicity: Providers may define the denominator population such that it is limited to one of the following options:
  1. White/Caucasian
  2. Black/African American
  3. Latino/Hispanic
  4. Asian
  5. American Indian/Alaskan Native
  6. Native Hawaiian/Other Pacific Islander
Age: Providers may define the denominator population such that it is limited to an age range:
Lower Bound: ____ (Provider defined)
Upper Bound: ____ (Provider defined)
Comorbid Condition: Providers may define the denominator population such that it is limited to individuals with one or more comorbid conditions:
Comorbid condition: ______(Provider defined)
Setting/Location: Providers may define the denominator population such that it is limited to individuals receiving services in a specific setting or service delivery location(s).
Service Setting/Delivery Location(s): ______(Provider defined)
Additional Considerations for Providers / From the survey developers:
"The MVQOLI has been validated only with patients 18 years or older, however, it has been used in practice with patients as young as 12.
in both research and reported experience, we find that clinicians tend to be too conservative in their use of the MVQOLI. Patients are much more receptive to the MVQOLI than clinicians think they will be.
"It is important to train the clinical team in using the MVQOLI quality of life profile for care planning. We feel strongly that administration of the instrument without follow up in terms of clinical care is irresponsible. Patients reveal feelings and concerns that should be understood and addressed by the clinical team."
From HHSC:
Providers should for follow survey administration, sampling, and scoring guidelines, unless a DSRIP specific modification has been noted. Surveys are validated in their entirety and providers should plan on using as specified by the survey developer.
Data Source / Survey Report
Demonstration Years / DY3
10/01/13 – 09/30/14 / DY4
10/01/14 – 09/30/15 / DY5
10/01/15 – 09/30/16
Measurement Periods
(Note: For P4P measures, DY3 Measurement Period is equivalent to the Baseline Period for purposes of measuring improvement.) / Providers must report data for one of the following DY, SFY, or CY time periods:
12 Month Period:
  1. 10/01/13 – 09/30/14, or
  2. 09/01/13 – 08/31/14, or
  3. 01/01/13 – 12/31/13, or
  4. 10/01/12 – 09/30/13, or
  5. 09/01/12 – 08/31/13
6 Month Period:
  1. 04/01/14 – 09/30/14, or
  2. 03/01/13 – 08/31/14, or
  3. 01/01/13 – 06/30/13, or
  4. 07/01/13 – 12/31/13
Other: Providers specify/propose an alternative 6 or 12 month time period to be reviewed and approved by HHSC. / Providers must report data across a 12-month time period that meets the following parameters:
1. Start date: The start date for the reporting period must occur after the provider’s DY3 Measurement Period.
2. End date: The end date for the reporting period must occur on or before 09/30/15. / Providers must report data across a 12-month time period that meets the following parameters:
1. Start date: The start date for the reporting period must occur after the provider’s DY4 Measurement Period.
2. End date: The end date for the reporting period must occur on or before 09/30/16.
Reporting Opportunities to HHSC / 10/31/2014 / 4/30/2015
10/31/2015 / 4/30/2016
10/31/2016
Pay for Performance Target Methodology / Not Applicable / Improvement Over Self / Improvement Over Self