SNF HAI is a one-year outcome measure that estimates the risk-standardized rate of healthcare-associated infections (HAIs) that are acquired during SNF care and result in hospitalization.

The PaLS is used to generate a patient-level t-score that reflects patient-reported satisfaction with how well his/her/their facility is doing in discussing life goals with the patient as part of the treatment planning process.

This measure is an all-or-none composite of the number of patients following an ICD/CRT-D implant procedure who received prescriptions for all medications (Angiotensin-converting enzyme inhibitors (ACE-I)/ Angiotensin receptor blockers (ARB)/ Angiotensin receptor-neprilysin inhibitors (ARNI) and beta blockers) for which they are eligible at discharge and those patients with procedures that fulfill class I, IIa, or IIb guideline indications.

The percentage of discharges for members 6 years of age and older who were hospitalized for treatment of selected mental illness or intentional self-harm diagnoses and who had at least five follow-up community-based mental health care visits in the 90 days after discharge.

Percentage of children aged 1 through 20 years who received at least 2 topical fluoride applications as oral health services within the reporting year.

Percentage of children aged 1 through 20 years who received at least 2 topical fluoride applications as dental or oral health services within the reporting year.

The measure is specified for reporting at the program (e.g., Medicaid, CHIP, Health Insurance Marketplaces) and plan (e.g., dental and health plans) levels for both public and private/commercial reporting. 

Percentage of women who 1) received or had documented use of most or moderately effective contraception and 2) received a long-acting reversible contraceptive method during the calendar year. 

To focus the measure  on the population of women interested in contraceptive services, the denominator excludes those individuals who did not receive or have documented use of a method if they indicated during the year that they did not want these services, as well as those who are eligible for postpartum contraceptive services during the measurement period.

This measure tracks the percentage of patients in each dialysis practitioner group practice who were on the kidney or kidney-pancreas transplant waitlist. Results are averaged across patients prevalent on the last day of each month during the reporting year.

Please note, this measure is at the dialysis practitioner level (the clinician who receives the Monthly Capitation Payment for overseeing dialysis care).

The proposed measure is a directly standardized percentage, which is adjusted for covariates (e.g. age and risk factors).

The inappropriate diagnosis of UTI in hospitalized medical patients (or “Inappropriate Diagnosis of UTI”) measure is a process measure that evaluates the annual proportion of hospitalized adult medical patients treated for UTI who do not meet diagnostic criteria for UTI (thus are inappropriately diagnosed and overtreated).