Use of Appropriate Medications for People with Asthma (AQA and HEDIS Measure) | Percentage of members with persistent asthma who received at least one prescription for an appropriate medication in the measurement year | | √ | √ | 6–12 mos | This measure might be good to track in the short- to medium- term (6–18 mos). |
Daily Preventive Medication | Percentage of members with asthma who self-report the use of a controller medication | - Case Data.
- Patient Survey.
| √ | √ | 6 mos | Patient self-report goals can be a good way to obtain information about an intervention's effects in a short timeframe (< 6 mos). |
Written Action Plan | Percentage of members with asthma who have a personal action plan for managing their asthma | - Case Data.
- Medical Record.
- Patient Survey.
| √ | √ | 3–6 mos | If an intervention uses action plans, this measure could be effective. |
Self-Management Goal | Percentage of members with asthma who have a self-management goal | - Case Data.
- Medical Record.
- Patient Survey.
| √ | √ | 3–6 mos | Patient self-report goals can be a good way to obtain information about an intervention's effects in a short timeframe. |
Emergency Room (ER) Use | Percentage of members who visited the ER for asthma in the past 12 mos | - Claims.
- Case Data.
- Patient Survey.
| √ | √ | 12–18 mos | Reducing ER visits can exert a significant impact on cost and quality of life. |
Physician Followup Post-ER Visit or Post-Hospitalization | Percentage of members who followed up with a physician after an ER visit or hospital admission | - Claims.
- Case Data.
- Medical Record.
| √ | √ | 12–18 mos | |
Influenza Vaccination | Percentage of all members with asthma who received a influenza vaccination within the past 12 mos | - Case Data.
- Medical Record.
- Patient Survey.
| √ | √ | 12–18 mos | Influenza vaccination can exert a significant impact on health care expenditures in members with asthma, particularly in epidemic years. The effect will, of course, be seasonal. |
HbA1c Screening (AQA and HEDIS Measure) | Percentage of members who received one or more HbA1c screenings in the measurement year | - Claims.
- Case Data.
- Medical Record.
- Patient Survey.
| √ | √ | 12 mos | Screening rates can be a good way to obtain information about an intervention's effects in a short timeframe. |
HbA1c Control(AQA and HEDIS Measure) | Percentage of members with diabetes with most recent LDL-C <130 mg/dl | - Claims.
- Case Data.
- Medical Record.
- Lab Results
| √ | √ | 12 mos | |
Low Density Lipoprotein Cholesterol (LDL-C) Screening (AQA and HEDIS Measure) | Percentage of members who received at least one LDL-C screening during the measurement year | - Claims.
- Case Data.
- Medical Record.
- Lab Results
| √ | √ | 12 mos | Screening rates can be a good way to obtain information about an intervention's effects in a short timeframe. |
LDL-C Level(<130mg/dl)(AQA Measure) | Percentage of members with diabetes with most recent LDL-C <130 mg/dl | - Claims.
- Case Data.
- Medical Record.
- Lab Results.
| √ | √ | 12 mos | Seeing a change in clinical outcomes, such as cholesterol levels, might take a year or more. |
LDL-C Level (<100mg/dl) (AQA and HEDIS Measure) | Percentage of members with diabetes with most recent LDL-C <100 mg/dl | - Claims.
- Case Data.
- Medical Record.
- Lab Results.
| √ | √ | 12 mos | Seeing a change in clinical outcomes, such as cholesterol levels, might take a year or more. |
Nephropathy Screening (HEDIS Measure) | Percentage of members with diabetes with a nephropathy screening or evidence of nephropathy | - Claims.
- Case Data.
- Medical Record.
| √ | √ | 12 mos | Screening rates can be a good way to obtain information about an intervention's effects in a short timeframe. |
Eye Examination (AQA and HEDIS Measure) | Percentage of members who received one dilated retinal examination in the measurement year | - Claims.
- Case Data.
- Medical Record.
- Patient Survey.
| √ | √ | 12 mos | Screening rates can be a good way to obtain information about an intervention's effects in a short timeframe. |
Foot Examination | Percentage of members with diabetes who received at least one foot examination from a health care provider | - Claims.
- Case Data.
- Medical Record.
- Patient Survey.
| √ | √ | 12 mos | Screening rates can be a good way to obtain information about an intervention's effects in a short timeframe. |
Blood Pressure (AQA and HEDIS Measure) | Percentage of members with diabetes with most recent blood pressure <140/90 mm Hg | - Claims.
- Case Data.
- Medical Record.
| √ | √ | 12 mos | Seeing a change in clinical outcomes, such as blood pressure, might take a year or more. |
ASA (aspirin)/Antiplatelet Therapy | Percentage of members with diabetes who were prescribed ASA/antiplatelet therapy | - Claims.
- Case Data.
- Medical Record.
| √ | √ | 6 mos | |
Self-Management Goal | Percentage of members with diabetes who have a self-management goal | - Case Data.
- Medical Record.
- Patient Survey.
| √ | √ | 6 mos | Self-management goals can be useful in gauging patient activation. |
Influenza Vaccination | Percentage of all members with diabetes who received a influenza vaccination within the past 12 mos | - Case Data.
- Medical Record.
- Patient Survey.
| √ | √ | 12 mos | |
LDL-C Intensification | Percentage of members with diabetes with: - Most recent LDL-C <100 mg/dl or
- LDL-C =100 mg/dl and on highest dose statin or
- Statin started or statin increased within 6 mos of last value
| - Case Data.
- Medical Record.
- Lab Results.
| √ | √ | 12 mos | This measure represents a more sensitive "hybrid" indicator of change in provider behavior and improved quality of care. |
New York Heart Association (NYHA) Functional Classification | Percentage of members who have documentation of NYHA classification | - Case Data.
- Medical Record.
| | √ | 12 mos | |
Blood Pressure | Percentage of members with congestive heart failure (CHF) with most recent blood pressure <140/80 mm Hg | - Claims.
- Case Data.
- Medical Record.
- Lab Results.
| √ | √ | 12 mos | Seeing a change in clinical outcomes, such as blood pressure, might take a year or more. |
Beta Blocker Therapy after a Heart Attack (HEDIS) | Percentage of members who were discharged from a hospital for AMI and received persistent beta-blocker treatment for 6 mos after discharge | | √ | √ | 6-12 mos | This measure could be good for tracking in the short- to medium-term (6–12 mos). |
Cholesterol Management for Patients with a Cardiovascular Condition (HEDIS) | Percentage of members who had a cholesterol screening in the measurement year after an AMI discharge | - Claims.
- Case Data.
- Medical Record.
- Lab Results.
| | √ | 12-18 mos | |
Left Ventricular Function (LVF) Assessment (AQA Measure) | Percentage of members with CHF who have the results of an LVF assessment recorded | - Claims.
- Case Data.
- Medical Record.
| | √ | 12-18 mos | |
ACE Inhibitor or Angiotensin Receptor (ARB) Therapy (AQA Measure) | Percentage of members who have CHF and an LVSD who were prescribed ACEI or ARB | | | √ | 6-12 mos | |
Emergency Room (ER) Use | Percentage of CHF members with an ER visit for CHF in the past 12 mos | | √ | √ | 12 mos | Reducing ER visits can exert a significant impact on cost and quality of life. |
Physician Followup Post-ER Visit or Post-Hospitalization | Percentage of CHF members who followed up with a physician within 30 days after an ER visit or hospital admission | - Claims.
- Case Data.
- Patient Survey.
| √ | √ | 12-18 mos | |
Self-Management Goal | Percentage of members with CHF who have a self-management goal | - Case Data.
- Medical Record.
- Patient Survey.
| √ | √ | 6 mos | Self-management goals can be useful in gauging patient activation. |
Weight Self-Monitoring | Percentage of CHF members who monitor their weight daily | - Case Data.
- Patient Survey.
| √ | √ | 6-12 mos | This goal is useful in assessing patient activation. |
Influenza Vaccination | Percentage of all members with CHF who received a influenza vaccination within the last 12 mos | - Case Data.
- Medical Record.
- Patient Survey.
| √ | √ | 12 mos | |