Health Plan

The risk-adjusted relative resource use by health plan members with COPD during the measurement year.

The risk-adjusted relative resource use by health plan members with diabetes (type 1 and type 2) during the measurement year.

This measure identifies adult patients with a history of rheumatoid arthritis who have received erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) lab tests during the measurement year.

This measure identifies adult patients with a diagnosis of rheumatoid arthritis who received appropriate baseline complete blood count (CBC) testing within 90 days before to 14 days after the new start of sulfasalazine, methotrexate, leflunomide, azathioprine, D-Penicillamine, intramuscular gold, oral gold, cyclosporine, or cyclophosphamide during the measurement year.

This measure identifies adult patients with a diagnosis of rheumatoid arthritis who received appropriate baseline liver function testing (AST or ALT) within 90 days before to 14 days after the new start of sulfasalazine, methotrexate, leflunomide, azathioprine, cyclosporine or cyclophosphamide during the measurement year.

This measure identifies adult patients with a diagnosis of rheumatoid arthritis who received appropriate baseline serum creatinine testing within 90 days before to 14 days after the new start of methotrexate, leflunomide, azathioprine, D-Penicillamine, intramuscular gold, cyclosporine, or cyclophosphamide during the measurement year.

The existing NQF-endorsed measure provides a means for determining the risk-adjusted readmission rate for a selected adult target population and can be applied for any desired timeframe. Readmission rate is defined as the percentage of acute inpatient discharges during the measurement period followed by an acute inpatient admission for any diagnosis to any hospital within 30 days

The percentage of adult patients, 21 years and older, with diagnosis of ischemic vascular disease (IVD) that are taking aspirin or an antiplatelet agent

The percentage of patients ages 40 to 75 years who were dispensed a medication for diabetes that receive a statin medication.

This measure identifies patients undergoing percutaneous coronary intervention (PCI) with placement of a drug-eluting intracoronary stent during the first 9 months of the measurement year, who filled a prescription for clopidogrel in the 3 months following stent placement.