The percentage of individuals 18 years and older who met the Proportion of Days Covered (PDC) threshold of 80 percent during the measurement year.
Report a rate for each of the following:
• Diabetes All Class (PDC-DR)
• Renin Angiotensin System Antagonists (PDC-RASA)
• Statins (PDC-STA)
A higher rate indicates better performance.
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1.5 Measure Type1.7 Electronic Clinical Quality Measure (eCQM)1.8 Level Of Analysis1.20 Testing Data Sources
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1.14 Numerator
The number of individuals who met the PDC threshold of 80 percent during the measurement year.
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1.15 Denominator
Individuals age 18 years and older as of the first day of the measurement year, with at least two prescription claims for medication(s) within a specific therapeutic category (Diabetes; RASA; Statins) on different dates of service during the treatment period and are continuously enrolled during the treatment period, which begins on the index prescription start date (IPSD) and extends through whichever comes first: the last day of the measurement year, death or disenrollment. The IPSD should occur at least 91 days before the end of the enrollment period.
Note: The IPSD is the earliest date of service for a target medication during the measurement year
Exclusions for the Diabetes rate:
- Individuals with one or more prescription claims for insulin during the treatment period (See Medication Table PDC-H: Insulin Exclusion)
- Individuals in hospice or with End-Stage Renal Disease
Exclusions for the RASA rate:
- Individuals with one or more prescription claims for the medication, sacubitril/valsartan during the treatment period (See Medication Table PDC-RASA-B: Sacubitril/Valsartan Exclusion)
- Individuals in hospice or with End-Stage Renal Disease
Exclusions for the Statins rate:
- Individuals in hospice or with End-Stage Renal Disease
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Exclusions
Exclusions for the Diabetes rate:
- Individuals with one or more prescription claims for insulin during the treatment period (See Medication Table PDC-H: Insulin Exclusion)
- Individuals in hospice or with end-stage renal disease during the measurement year
Exclusions for the RASA rate:
- Individuals with one or more prescription claims for the medication, sacubitril/valsartan during the treatment period (See Medication Table PDC-RASA-B: Sacubitril/Valsartan Exclusion)
- Individuals in hospice or with End-Stage Renal Disease
Exclusions for the Statins rate:
- Individuals in hospice or with End-Stage Renal Disease
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1.13a Data dictionary not attachedNo
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Most Recent Endorsement ActivityEndorsed Primary Care and Chronic Illness Spring Cycle 2019Initial EndorsementLast Updated
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StewardPharmacy Quality AllianceSteward Organization POC EmailSteward Organization URLSteward Organization Copyright
COPYRIGHT 2019 PQA, INC. ALL RIGHTS RESERVED. PQA retains all rights of ownership to the measures contained in this Manual and can rescind or alter the measures at any time. No use of any PQA measure is authorized without prior PQA approval of such use. All uses of PQA measures are subject to such conditions as PQA specifies, and certain uses of the measures may be subject to a licensing agreement specifying the terms of use and the licensing fee. Users of the measure shall not have the right to alter, enhance, or otherwise modify the measures.
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Risk AdjustmentRisk adjustment approachOffRisk adjustment approachOffConceptual model for risk adjustmentOffConceptual model for risk adjustmentOff
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6.1.2 Current or Planned Use(s)6.1.3 Current Use(s)
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Use In Federal Program
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