Hospitalization for Ambulatory Care Sensitive Conditions for Dual Eligible Beneficiaries

For dual eligible beneficiaries age 18 years and older, state-level observed and risk-adjusted rates of hospital admissions for ambulatory care sensitive conditions (ACSC) per 1,000 beneficiaries for ACSC by chronic and acute conditions. This measure has three rates reported as both observed and risk-adjusted rates:
• Chronic Conditions Composite
• Acute Conditions Composite
• Total (Acute and Chronic Conditions) Composite
The observed and risk-adjusted rates are stratified and reported for three populations: (1) community-dwelling home and community-based services (HCBS) users; (2) community-dwelling non-HCBS users; or, (3) non-community-dwelling (institutionalized) population.

This measure is planned for public reporting and quality improvement at the state level. This population health measure can help states understand the underlying quality of outpatient care, including home- and community-based services, provided to dual eligible beneficiaries for acute conditions, chronic conditions, and overall. The state-level measure can assess the quality of a breadth of outpatient services by providers that may not be linked to a single accountable healthcare facility.