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Populations at Risk: Dual eligible beneficiaries

Adherence to Statin Therapy for Individuals with Cardiovascular Disease

  • The percentage of individuals with cardiovascular disease (CVD), including coronary artery disease, cerebrovascular disease, and peripheral artery disease presumed to be of atherosclerotic origin, who are prescribed statin therapy that had a Proportion of Days Covered (PDC) for statin medications of at least 0.8 during the measurement period (12 consecutive months).

    CBE ID
    0543

Assessment of Health-related Quality of Life in Dialysis Patients

  • Percentage of eligible dialysis patients who complete a health-related quality of life assessment with or without assistance using the KDQOL-36 (36-question survey that assesses patients´ functioning and well-being) at least once during a calendar year.

    CBE ID
    0260

Fall Risk Management (FRM)

  • Assesses different facets of fall risk management:

    Discussing Fall Risk. The percentage of adults 75 years of age and older, or 65–74 years of age with balance or walking problems or a fall in the past 12 months, who were seen by a practitioner in the past 12 months and who discussed falls or problems with balance or walking with their current practitioner.

    CBE ID
    0035

Medical Home System Survey (MHSS)

  • The Medical Home System Survey (MHSS) assesses the degree to which an individual primary-care practice or provider has in place the structures and processes of an evidence-based Patient Centered Medical Home. The survey is composed of six composites. Each measure is used to assess a particular domain of the patient-centered medical home.

    Composite 1: Patient-Centered Access
    Composite 2: Team-Based Care
    Composite 3: Population Health Management
    Composite 4: Care Management and Support
    Composite 5: Care Coordination and Care Transitions

    CBE ID
    1909

Medication Reconciliation Post-Discharge (MRP)

  • The percentage of discharges during the first 11 months of the measurement year (e.g., January 1–December 1) for patients 66 years of age and older for whom medications were reconciled on or within 30 days of discharge.

    CBE ID
    0554

Perioperative Temperature Management

  • Percentage of patients, regardless of age, who undergo surgical or therapeutic procedures under general or neuraxial anesthesia of 60 minutes duration or longer for whom at least one body temperature greater than or equal to 35.5 degrees Celsius (or 95.9 degrees Fahrenheit) was recorded within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time

    CBE ID
    0454

Physical Activity in Older Adults (PAO)

  • This measure has two rates that assess the promotion of physical activity in older adults:

    Discussing Physical Activity: Percentage patients 65 years of age and older who reported discussing their level of exercise or physical activity with a doctor or other health provider in the last 12 months

    Advising Physical Activity: Percentage patients 65 years of age and older who reported receiving advice to start, increase, or maintain their level of exercise or physical activity from a doctor or other health provider in the last 12 months

    CBE ID
    0029

Procedures and Tests

  • Performance Measure Name: Procedures and Tests
    Description: Patients who are transferred from an ED to another healthcare facility have communicated with the receiving facility within 60 minutes of discharge a list of tests done and results sent.

    CBE ID
    0297

Proportion of Patients Hospitalized with AMI that have a Potentially Avoidable Complication (during the Index Stay or in the 30-day Post-Discharge Period)

  • Percent of adult population aged 18 + years who are admitted to a hospital with acute myocardial infarction (AMI), are followed for one-month after discharge, and have one or more potentially avoidable complications (PACs). PACs may occur during the index stay or during the 30-day post discharge period. Please reference attached document labeled NQF_AMI_all_codes_risk_adjustment_06.30.15.xls, in the tabs labeled PACs I-9 and PAC I-10 for a list of code definitions of PACs relevant to AMI.

    We define PACs during each time period as one of two types:

    CBE ID
    0704