Health Plan

The percentage of patients 2 years or older with asthma who have a refill for a short-acting beta agonist in the past 12 months.

Percentage of patients with asthma who have greater than or equal to one visit to the emergency room for asthma during the measurement period.

The percentage of patients 5–64 years of age who were identified as having persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater during the measurement year.

The percentage of patients aged 12 years and older with coronary artery disease, or 18 years and older with cerebrovascular disease or peripheral vascular disease that have been screened for dyslipidemia with a lipid profile

The percentage of patients aged 18 and older with a diagnosis of atherosclerotic disease whose most recent LDL-C value is greater than 100 mg/dL and who are taking a lipid lowering agent

Percentage of adult patients aged 25 and older with atrial fibrillation and major stroke risk factors who are on anticoagulation therapy.

The percentage of episodes for members ages 3 months and older with a diagnosis of acute bronchitis/bronchiolitis that did not result in an antibiotic dispensing event.

This measure identifies the percentage of patients with newly diagnosed bipolar disorder who have received at least 1 prescription for a mood-stabilizing agent during the measurement year.

The percentage of patients 18 years and older with a serious mental illness who received a screening for body mass index and follow-up for those people who were identified as obese (a body mass index greater than or equal to 30 kg/m2).

Note: The proposed health plan measure is adapted from an existing provider-level measure for the general population (Preventive Care & Screening: Body Mass Index: Screening and Follow-Up NQF #0421). It is currently stewarded by CMS and used in the Physician Quality Reporting System.

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer